| NPI | 1982724241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE R MARTIN Office Manager 803-649-4337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: SC 16926) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-08-22 |