Provider First Line Business Practice Location Address:
501 W BUTLER AVE
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:
29138-1313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-445-2250
Provider Business Practice Location Address Fax Number:
877-870-2854
Provider Enumeration Date:
12/27/2005