Provider First Line Business Practice Location Address:
129 N. WASHINGTON ST.
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-436-5582
Provider Business Practice Location Address Fax Number:
803-436-0085
Provider Enumeration Date:
03/23/2006