| NPI | 1972165041 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ELIZA KATHLEEN MCCORMICK Billing & Credentiaing Manager 864-920-2527  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty | 
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics | 
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2019-06-28 | 
| Last Update Date | 2019-06-28 |