Provider First Line Business Practice Location Address:
TIERNEY ORTHOTICS AND PROSTHETICS INC
Provider Second Line Business Practice Location Address:
1345 WESTGATE CENTER DR, STE B
Provider Business Practice Location Address City Name:
WINSTON SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-546-7165
Provider Business Practice Location Address Fax Number:
866-403-2483
Provider Enumeration Date:
09/13/2011