Provider First Line Business Practice Location Address:
910 WORTH STREET
Provider Second Line Business Practice Location Address:
FOOTHILLS PRIMARY CARE
Provider Business Practice Location Address City Name:
MOUNT AIRY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-716-2255
Provider Business Practice Location Address Fax Number:
336-783-6842
Provider Enumeration Date:
08/09/2005