Provider First Line Business Practice Location Address:
5110 FAIRFIELD ROAD
Provider Second Line Business Practice Location Address:
PALMETTO SENIOR CARE EAU CLAIRE
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-691-5650
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/29/2006