Provider First Line Business Practice Location Address:
2244 BROWNTOWN RD
Provider Second Line Business Practice Location Address:
SWCMHC/EMERALD CRCF
Provider Business Practice Location Address City Name:
BISHOPVILLE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29010-9664
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-428-6052
Provider Business Practice Location Address Fax Number:
803-428-5406
Provider Enumeration Date:
05/05/2006