| NPI | 1912950775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NINA C GODFREY Office Manager 864-351-0332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NS0135X Dermatology Procedural Dermatology (Licence: SC 6924) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2011-08-04 |