| NPI | 1972541944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS CHARLES BELLER Owner 843-689-6442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KI0005X Allergy & Immunology Clinical & Laboratory Immunology (Licence: 26810) |
| Additional Taxonomies | 207K00000X Allergy & Immunology |
| 207K00000X Allergy & Immunology (Licence: SC 26810) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2012-05-08 |