Provider First Line Business Practice Location Address:
201 N BANKS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALUDA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29138
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-445-8124
Provider Business Practice Location Address Fax Number:
864-445-9504
Provider Enumeration Date:
08/25/2006