Provider First Line Business Practice Location Address:
SWCMHC/ACT, 764 WEST LIBERTY ST.
Provider Second Line Business Practice Location Address:
2 MEDICAL CT.
Provider Business Practice Location Address City Name:
SUMTER
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29151-1946
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-778-4195
Provider Business Practice Location Address Fax Number:
803-778-6598
Provider Enumeration Date:
05/22/2006