Provider First Line Business Practice Location Address:
129 E COUNCIL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALISBURY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28144-5019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
980-701-0705
Provider Business Practice Location Address Fax Number:
980-701-0706
Provider Enumeration Date:
08/28/2024