Provider First Line Business Practice Location Address:
100 PALMETTO HEALTH PKWY STE 320
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:
29212-1756
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-296-9200
Provider Business Practice Location Address Fax Number:
803-296-9697
Provider Enumeration Date:
07/03/2017