Provider First Line Business Practice Location Address:
2033 MEDICAL PARK DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWBERRY
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-276-5188
Provider Business Practice Location Address Fax Number:
803-276-9317
Provider Enumeration Date:
10/26/2006