Provider First Line Business Practice Location Address:
350 SCHOOL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAYLORSVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28681-2340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-635-8989
Provider Business Practice Location Address Fax Number:
828-635-5554
Provider Enumeration Date:
09/23/2005