Provider First Line Business Practice Location Address:
215 WEST POINSETT STREET
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
GREER
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29650
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-877-1891
Provider Business Practice Location Address Fax Number:
864-877-3664
Provider Enumeration Date:
07/29/2009