| NPI | 1952147498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY BAILLEY Member 864-527-1250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 208D00000X General Practice |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2025-08-07 |