Provider First Line Business Practice Location Address:
29 LEINBACH DR #B
Provider Second Line Business Practice Location Address:
MUSC INSTITUTE OF PSYCHIATRY
Provider Business Practice Location Address City Name:
CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-792-9228
Provider Business Practice Location Address Fax Number:
843-792-9130
Provider Enumeration Date:
12/27/2006