Provider First Line Business Practice Location Address:
140 S SCALES ST STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REIDSVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27320-3834
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-280-1358
Provider Business Practice Location Address Fax Number:
336-347-0248
Provider Enumeration Date:
11/03/2025