Provider First Line Business Practice Location Address:
EMERGENCY MEDICINE
Provider Second Line Business Practice Location Address:
14 MEDICAL PARK, STE 350
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:
803-434-3790
Provider Business Practice Location Address Fax Number:
803-434-6299
Provider Enumeration Date:
06/16/2020