Provider First Line Business Practice Location Address:
1834 REYNOLDA ROAD
Provider Second Line Business Practice Location Address:
MACKIE HEALTH CENTER - REYNOLDS GYM - WINGATE RD. WFU
Provider Business Practice Location Address City Name:
WINSTON-SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-758-5218
Provider Business Practice Location Address Fax Number:
336-758-6054
Provider Enumeration Date:
02/12/2007