Provider First Line Business Practice Location Address:
1102 S EBENEZER RD
Provider Second Line Business Practice Location Address:
SNEED MIDDLE SCHOOL
Provider Business Practice Location Address City Name:
FLORENCE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29501-8009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-673-1199
Provider Business Practice Location Address Fax Number:
843-679-6890
Provider Enumeration Date:
05/20/2013