| NPI | 1851636062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH D OGLESBY Director 864-630-8989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: SC 11110111) |
| Additional Taxonomies | 251S00000X (Licence: SC 1210026) |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2012-11-29 |