Provider First Line Business Practice Location Address:
1211 S. JEFFERSON ST.
Provider Second Line Business Practice Location Address:
CARILION CLINIC CANCER GENETICS PROGRAM
Provider Business Practice Location Address City Name:
ROANOKE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24016-4705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-521-9941
Provider Business Practice Location Address Fax Number:
540-857-9130
Provider Enumeration Date:
12/12/2006