| NPI | 1932383866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE CODY Mccr Supervisor 843-789-6352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: SC 827569) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2007-12-27 |