| NPI | 1821631706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MCGILL Manager 803-318-2811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2019-10-23 |