| NPI | 1942799291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN JOSEPH PALMER Provider 864-879-6494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: SC 2544) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC 2544) |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2018-05-02 |