Provider First Line Business Practice Location Address:
40 OKATIE CENTER BLVD S.
Provider Second Line Business Practice Location Address:
SUITE 205 BLUFFTON-OKATIE OUTPATIENT CENTER
Provider Business Practice Location Address City Name:
OKATIE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-705-8970
Provider Business Practice Location Address Fax Number:
843-705-7034
Provider Enumeration Date:
10/27/2006