Provider First Line Business Practice Location Address:
2430 NC HWY 90 EAST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAYLORSVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28681-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-632-7397
Provider Business Practice Location Address Fax Number:
828-632-4167
Provider Enumeration Date:
05/28/2006