Provider First Line Business Practice Location Address:
509 BROOKDALE DR
Provider Second Line Business Practice Location Address:
YOUNG FAMILY PRACTICE
Provider Business Practice Location Address City Name:
STATESVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28677-4107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-924-7992
Provider Business Practice Location Address Fax Number:
704-924-7950
Provider Enumeration Date:
08/23/2005