Provider First Line Business Practice Location Address:
1928 WEDDINGTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEDDINGTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-849-0344
Provider Business Practice Location Address Fax Number:
704-849-0521
Provider Enumeration Date:
07/05/2007