Provider First Line Business Practice Location Address:
2 MEDICAL CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUMTER
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29150-4760
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-774-4020
Provider Business Practice Location Address Fax Number:
803-774-4025
Provider Enumeration Date:
12/07/2010