Provider First Line Business Practice Location Address:
400 PALMETTO HEALTH PKWY
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-434-8721
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/08/2015