Provider First Line Business Practice Location Address:
1105-3 E DIXON BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHELBY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28152
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-669-4000
Provider Business Practice Location Address Fax Number:
704-669-2535
Provider Enumeration Date:
07/06/2006