| NPI | 1861929473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANTHONY WALDROP President 803-276-7320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: SC 2102) |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2017-05-12 |