Provider First Line Business Practice Location Address:
237 N HOSPITAL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENWOOD
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29646-2962
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-223-8434
Provider Business Practice Location Address Fax Number:
864-223-9546
Provider Enumeration Date:
06/27/2008