| NPI | 1992296172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA JENNINGS STARLING Sole Owner 864-457-2033 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 14152) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-05-23 |