Provider First Line Business Practice Location Address:
CAROLINA MEDICAL GROUP 3010 FARROW ROAD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-799-1264
Provider Business Practice Location Address Fax Number:
803-376-1163
Provider Enumeration Date:
03/30/2006