Provider First Line Business Practice Location Address:
801 GROVE ROAD
Provider Second Line Business Practice Location Address:
GREENVILLE HOSPITAL SYSTEM UNIVERSITY MEDICAL CENTER
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-455-4912
Provider Business Practice Location Address Fax Number:
864-455-1637
Provider Enumeration Date:
02/09/2007