Provider First Line Business Practice Location Address:
PALMETTO HEALTH BAPTIST
Provider Second Line Business Practice Location Address:
TAYLOR AT MARION STREET
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29220-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-296-2276
Provider Business Practice Location Address Fax Number:
806-296-3854
Provider Enumeration Date:
08/27/2008