Provider First Line Business Practice Location Address:
116 HOSPITAL SQ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BISHOPVILLE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29010-7081
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-484-9424
Provider Business Practice Location Address Fax Number:
803-483-2062
Provider Enumeration Date:
10/03/2018