Provider First Line Business Practice Location Address:
12020 UNIVERSITY CITY BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28075-8466
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-455-2211
Provider Business Practice Location Address Fax Number:
704-455-8246
Provider Enumeration Date:
06/11/2006