Provider First Line Business Practice Location Address:
1213 GREENSBORO RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIGH POINT
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27260-2609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-991-2427
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/29/2006