Provider First Line Business Practice Location Address:
997 E LIBERTY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29745-2689
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
180-368-4335
Provider Business Practice Location Address Fax Number:
180-368-4123
Provider Enumeration Date:
02/17/2010