Provider First Line Business Practice Location Address:
PT CLINIC, DEPARTMENT OF EXERCISE SCIENCE
Provider Second Line Business Practice Location Address:
UNIVERSITY OF SOUTH CAROLINA
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29208-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-777-0478
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/22/2006