| NPI | 1952530727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE WELLS Administrator 803-316-9056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 9114) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2009-07-14 |