Provider First Line Business Practice Location Address:
807 SCHENCK ST # 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHELBY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28150-3933
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-480-0222
Provider Business Practice Location Address Fax Number:
704-480-6007
Provider Enumeration Date:
01/11/2007