| NPI | 1881604114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAROLINE K KIRVEN Office Manger 803-469-4028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: SC 4919) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2018-05-01 |