Provider First Line Business Practice Location Address:
606 N ELM ST
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:
27262-4332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-889-8877
Provider Business Practice Location Address Fax Number:
336-885-5250
Provider Enumeration Date:
02/19/2009