Provider First Line Business Practice Location Address:
309 NEW ST
Provider Second Line Business Practice Location Address:
CAROLINA KIDNEY ASSOCIATES
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27405-3654
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-379-9708
Provider Business Practice Location Address Fax Number:
336-553-2085
Provider Enumeration Date:
03/26/2007