Provider First Line Business Practice Location Address:
74 PHYSICIAN DR.
Provider Second Line Business Practice Location Address:
AIKEN PEDIATRICS, P.A.
Provider Business Practice Location Address City Name:
AIKEN
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29801-6388
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-649-0578
Provider Business Practice Location Address Fax Number:
803-649-2788
Provider Enumeration Date:
10/02/2006