Provider First Line Business Practice Location Address:
136 E PARRIS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIGH POINT
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27262-7709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-442-1392
Provider Business Practice Location Address Fax Number:
336-885-1060
Provider Enumeration Date:
02/02/2010