Provider First Line Business Practice Location Address:
1668 N C HIGHWAY 16 SOUTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAYLORSVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28681
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-632-9736
Provider Business Practice Location Address Fax Number:
828-632-9544
Provider Enumeration Date:
07/12/2006