Provider First Line Business Practice Location Address:
791 JONESTOWN RD
Provider Second Line Business Practice Location Address:
DEPT OF PSYCHIATRY
Provider Business Practice Location Address City Name:
WINSTON SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27103-1252
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-716-5222
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/21/2013