Provider First Line Business Practice Location Address:
2100 BULL STREET
Provider Second Line Business Practice Location Address:
TB DIVISION DHEC
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-722-0179
Provider Business Practice Location Address Fax Number:
803-898-0685
Provider Enumeration Date:
04/02/2014