Provider First Line Business Practice Location Address:
601 MOCKSVILLE AVE
Provider Second Line Business Practice Location Address:
STE 1
Provider Business Practice Location Address City Name:
SALISBURY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28144
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-633-4686
Provider Business Practice Location Address Fax Number:
704-633-4404
Provider Enumeration Date:
10/26/2005