| NPI | 1952831505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES S CLARKE Speech Language Pathologist 803-384-0521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246Q00000X Specialist/Technologist, Pathology (Licence: SC 1861653933) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2022-07-21 |