Provider First Line Business Practice Location Address:
115 E CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BATESBURG-LEESVILLE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29070-7595
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-532-5226
Provider Business Practice Location Address Fax Number:
803-532-5356
Provider Enumeration Date:
02/13/2014