| NPI | 1982625828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA JEAN FROST Office Manager/Nurse 843-815-5211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: SC 27106) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2007-10-17 |