Provider First Line Business Practice Location Address:
1751 CALHOUN ST.
Provider Second Line Business Practice Location Address:
DHEC HEALTH SERVICES
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-898-0801
Provider Business Practice Location Address Fax Number:
803-898-0557
Provider Enumeration Date:
01/03/2007