Provider First Line Business Practice Location Address:
595 NEWBERRY HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALUDA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29138-7808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-254-3278
Provider Business Practice Location Address Fax Number:
803-376-8010
Provider Enumeration Date:
09/08/2011