Provider First Line Business Practice Location Address:
S CAROLINA DEPT OF CORRECTIONS
Provider Second Line Business Practice Location Address:
REDEMPTION WAY
Provider Business Practice Location Address City Name:
MC CORMICK
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29899-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-734-0330
Provider Business Practice Location Address Fax Number:
864-443-2121
Provider Enumeration Date:
02/10/2009