Provider First Line Business Practice Location Address:
100 MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOODRUFF
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29388-8704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-476-8191
Provider Business Practice Location Address Fax Number:
864-476-8193
Provider Enumeration Date:
04/18/2006