Provider First Line Business Practice Location Address:
150 FOSTER ST
Provider Second Line Business Practice Location Address:
COWPENS MIDDLE SCHOOL
Provider Business Practice Location Address City Name:
COWPENS
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29330-8901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-279-6400
Provider Business Practice Location Address Fax Number:
864-279-6455
Provider Enumeration Date:
04/30/2013