Provider First Line Business Practice Location Address:
1 MEDICAL CENTER BLVD. WAKE FOREST BAPTIST MEDICAL CENT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINSTON-SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27157
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-771-4398
Provider Business Practice Location Address Fax Number:
503-413-4898
Provider Enumeration Date:
04/24/2019