Provider First Line Business Practice Location Address:
807 E FARRISS AVE
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:
27262-3325
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-882-7721
Provider Business Practice Location Address Fax Number:
336-882-3725
Provider Enumeration Date:
02/14/2007