| NPI | 1922345529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL KOOISTRA Physician 864-585-6179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 13349) |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2020-03-27 |