Provider First Line Business Practice Location Address:
613 NEWBERRY HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALUDA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29138-8903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-445-2141
Provider Business Practice Location Address Fax Number:
864-445-7668
Provider Enumeration Date:
03/18/2014