Provider First Line Business Practice Location Address:
223 FAITH ROAD
Provider Second Line Business Practice Location Address:
SPACE I
Provider Business Practice Location Address City Name:
SALISBURY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28146
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-636-7789
Provider Business Practice Location Address Fax Number:
704-636-4284
Provider Enumeration Date:
10/17/2006