Provider First Line Business Practice Location Address:
300 PALMETTO HEALTH PKWY STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29212-1761
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-907-7100
Provider Business Practice Location Address Fax Number:
803-907-7109
Provider Enumeration Date:
07/27/2006