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COLUMBIA, SC
NPI1881077865
Entity TypeOrganization
Authorized ContactLATIANA MCDANIEL
CEO
864-310-8717
Organization Subpart ?No
Primary Taxonomy302F00000X Exclusive Provider Organization
Enumeration Date2015-07-08
Last Update Date2015-07-08
Business Address
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2601 READ ST STE I7
COLUMBIA, SC 29204-7861
Phone number: 864-310-8717
Mailing Address
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18 BERRYHILL RD APT 17F
COLUMBIA, SC 29210-6427
Phone number: 864-310-8717
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