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:
864-445-2500
Provider Business Practice Location Address Fax Number:
864-445-3956
Provider Enumeration Date:
04/12/2006