Provider First Line Business Practice Location Address:
LEATH CORRECTIONAL INSTITUTE FOR WOMEN
Provider Second Line Business Practice Location Address:
2809 AIRPORT RD.
Provider Business Practice Location Address City Name:
GREENWOOD
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29649-9212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-896-1035
Provider Business Practice Location Address Fax Number:
803-896-1049
Provider Enumeration Date:
03/07/2007