Provider First Line Business Practice Location Address:
242 TURNERSBURG HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STATESVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28625-2797
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-550-0821
Provider Business Practice Location Address Fax Number:
919-719-3645
Provider Enumeration Date:
05/01/2012