| NPI | 1881152627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD LEWIS Owner 843-823-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2019-12-16 |