NPI | 1831252477 |
---|---|
Entity Type | Organization |
Authorized Contact | LORI NOEL MOCK Practice Administrator 843-524-8171 |
Organization Subpart ? | No |
Primary Taxonomy | 2086S0129X |
Additional Taxonomies | 208600000X Surgery |
Enumeration Date | 2006-12-18 |
Last Update Date | 2025-09-11 |