| NPI | 1912651647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER M EVANS Owner 843-992-7604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2022-02-10 |