| NPI | 1972109353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAY J PRYOR Director Of Operations 803-386-0475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health |
| 207QA0505X Family Medicine, Adult Medicine | |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2022-02-22 |