Provider First Line Business Practice Location Address:
9302 MEDICAL PLAZA DRIVE STE C
Provider Second Line Business Practice Location Address:
AGAPE SENIOR PRIMARY CARE, INC.
Provider Business Practice Location Address City Name:
CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29406-9142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-491-0909
Provider Business Practice Location Address Fax Number:
843-353-2581
Provider Enumeration Date:
01/16/2009