Provider First Line Business Practice Location Address:
8811 WARREN H ABERNATHY HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPARTANBURG
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29301-1550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-574-7282
Provider Business Practice Location Address Fax Number:
864-574-7664
Provider Enumeration Date:
08/18/2005