| NPI | 1811165368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT WALL Practice Administrator 843-572-5990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: SC 13512) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2008-02-19 |