Provider First Line Business Practice Location Address:
1414 E FRANKLIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONROE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28112-5160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-289-5233
Provider Business Practice Location Address Fax Number:
704-289-2009
Provider Enumeration Date:
10/25/2007