Provider First Line Business Practice Location Address:
THE CITADEL INFIRMARY
Provider Second Line Business Practice Location Address:
171 MOULTRIE STREET
Provider Business Practice Location Address City Name:
CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29409-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-953-6847
Provider Business Practice Location Address Fax Number:
843-953-5283
Provider Enumeration Date:
07/11/2006