| NPI | 1811950645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY V MCCOLLUM Business Office Director 864-253-8063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2018-06-20 |