Provider First Line Business Practice Location Address:
2201 STATESVILLE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALISBURY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28147-7108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-636-0588
Provider Business Practice Location Address Fax Number:
704-639-1146
Provider Enumeration Date:
12/28/2006