Provider First Line Business Practice Location Address:
130 S POST RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHELBY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28152-6211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-487-0661
Provider Business Practice Location Address Fax Number:
704-480-5493
Provider Enumeration Date:
07/10/2007