| NPI | 1831370857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL ISSAC MITCHELL Physician 803-736-4050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: SC 8063) |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2007-11-19 |