Provider First Line Business Practice Location Address:
1023 CREEKSIDE MEDICAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29745-8624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-684-3730
Provider Business Practice Location Address Fax Number:
803-684-3808
Provider Enumeration Date:
10/26/2016