Provider First Line Business Practice Location Address:
4899 CAROLINA HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENMARK
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29042-1675
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-793-6000
Provider Business Practice Location Address Fax Number:
803-793-6192
Provider Enumeration Date:
03/25/2008