Provider First Line Business Practice Location Address:
1122 N MAIN 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:
28144-3614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-636-0741
Provider Business Practice Location Address Fax Number:
704-636-0793
Provider Enumeration Date:
03/03/2008