Provider First Line Business Practice Location Address:
164 RODERS ST
Provider Second Line Business Practice Location Address:
MOUNTAIN VIEW ADULT CARE RESIDENCE INC
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24266-1148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-899-2783
Provider Business Practice Location Address Fax Number:
276-889-3971
Provider Enumeration Date:
11/03/2006