Provider First Line Business Practice Location Address:
127 HEALTH CARE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PENNINGTON GAP
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24277-2853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-546-1440
Provider Business Practice Location Address Fax Number:
276-546-5759
Provider Enumeration Date:
11/07/2006