| NPI | 1972756609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE LEE LANIER-SMITH Practice Manager 803-425-1330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 15151) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: SC 15151) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2011-03-24 |