Provider First Line Business Practice Location Address:
229 SALUDA SPRINGS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29072
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-359-0505
Provider Business Practice Location Address Fax Number:
803-359-2206
Provider Enumeration Date:
11/17/2006