Provider First Line Business Practice Location Address:
685 SC HIGHWAY 283
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLUM BRANCH
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29845-2228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-215-7059
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/13/2023