Provider First Line Business Practice Location Address:
1 HICKMAN STREET
Provider Second Line Business Practice Location Address:
AGAPE PHYSICIANS CARE
Provider Business Practice Location Address City Name:
GRANITEVILLE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29829-2955
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-663-9224
Provider Business Practice Location Address Fax Number:
803-663-8893
Provider Enumeration Date:
05/20/2006