Provider First Line Business Practice Location Address:
2290 STATESVILLE BLVD
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:
28147-9166
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-633-1322
Provider Business Practice Location Address Fax Number:
704-633-2293
Provider Enumeration Date:
09/20/2006