Provider First Line Business Practice Location Address:
3833 HIGH POINT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27407-4649
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-852-7530
Provider Business Practice Location Address Fax Number:
336-759-2226
Provider Enumeration Date:
06/16/2005