Provider First Line Business Practice Location Address:
212 E INNES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALISBURY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28144-5010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-633-4456
Provider Business Practice Location Address Fax Number:
704-633-4618
Provider Enumeration Date:
03/28/2007