Provider First Line Business Practice Location Address:
833 MONTLIEU AVE
Provider Second Line Business Practice Location Address:
DEPT. OF ATHLETIC TRAINING
Provider Business Practice Location Address City Name:
HIGH POINT
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27262-4221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-841-4520
Provider Business Practice Location Address Fax Number:
336-841-9182
Provider Enumeration Date:
02/24/2010