Provider First Line Business Practice Location Address:
88 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRANITE FALLS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28630-1934
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-523-8181
Provider Business Practice Location Address Fax Number:
828-523-8182
Provider Enumeration Date:
06/30/2022