Provider First Line Business Practice Location Address:
300 RIDGE MEDICAL PLAZA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDGEFIELD
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29824-4525
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-384-4140
Provider Business Practice Location Address Fax Number:
803-384-4141
Provider Enumeration Date:
09/24/2025