Provider First Line Business Practice Location Address:
1730 KERNERSVILLE MEDICAL PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KERNERSVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27284-7197
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-765-5470
Provider Business Practice Location Address Fax Number:
336-499-5428
Provider Enumeration Date:
01/03/2017