| NPI | 1841055092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRODERICK HEKKING Mso 864-481-0935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2024-02-16 |
| Last Update Date | 2025-03-03 |