Provider First Line Business Practice Location Address:
1625 THERMAL CITY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNION MILLS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28167-8850
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-364-0153
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/14/2026