Provider First Line Business Practice Location Address:
1133-B HIGHWAY 9 BYPASS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29720-1709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-285-2225
Provider Business Practice Location Address Fax Number:
804-285-2333
Provider Enumeration Date:
06/08/2006