Provider First Line Business Practice Location Address:
2060 NORTHBROOK BLVD STE 103
Provider Second Line Business Practice Location Address:
CAROLINA CHILDRENS THERAPY DBA
Provider Business Practice Location Address City Name:
N CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29406-9811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-572-2450
Provider Business Practice Location Address Fax Number:
843-572-2451
Provider Enumeration Date:
01/30/2006