| NPI | 1871230870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH MARIE DISHER Owner 803-840-4772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| 363LP2300X Nurse Practitioner Primary Care | |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2022-06-10 |