Provider First Line Business Practice Location Address:
614 HOWARD ST
Provider Second Line Business Practice Location Address:
APPALACHIAN STATE UNIVERSITY BOX 32070
Provider Business Practice Location Address City Name:
BOONE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28608-5021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-262-3100
Provider Business Practice Location Address Fax Number:
828-262-6958
Provider Enumeration Date:
09/26/2005