| NPI | 1922192194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL MANDUS JOHNSON CEO Doctor 843-681-3777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: SC 18011) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-01-15 |