| NPI | 1992739015 |
|---|---|
| Doing Business As | LAKE RIDGE FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | MELINDA P KRUZNER CFO & Sr. VP 803-791-2000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2010-06-01 |