Provider First Line Business Practice Location Address:
200 W PARK CIR
Provider Second Line Business Practice Location Address:
SUITE C, WILKES REGIONAL FAMILY MEDICINE
Provider Business Practice Location Address City Name:
NORTH WILKESBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28659-3541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-903-7870
Provider Business Practice Location Address Fax Number:
336-903-7871
Provider Enumeration Date:
10/11/2006