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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARCUS A MCGIRT (DIRECTOR/CEO)
(843) 632-1503
Entity
Organization

Contact information

Practice address
3752 HIGHWAY 34 W, LATTA, SC 29565-4485
(843) 632-1503
Mailing address
3752 HIGHWAY 34 W, LATTA, SC 29565-4485
(843) 632-1503

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
10/20/2020
Last updated
10/20/2020
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