Provider First Line Business Practice Location Address:
709 MILL ST
Provider Second Line Business Practice Location Address:
THE ALPHA CENTER
Provider Business Practice Location Address City Name:
CAMDEN
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29020-4738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-432-6902
Provider Business Practice Location Address Fax Number:
803-432-6890
Provider Enumeration Date:
12/18/2013