Provider First Line Business Practice Location Address:
8311 WARREN H ABERNATHY HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPARTENBURG
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29301-1249
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-562-5136
Provider Business Practice Location Address Fax Number:
864-560-4413
Provider Enumeration Date:
06/03/2006