| NPI | 1881905032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN KELLY WHITE Owner 843-626-2847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: SC 22830) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2010-06-23 |