Provider First Line Business Practice Location Address:
220 EAST FIRST AVE. EXT.
Provider Second Line Business Practice Location Address:
STE. 10
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27292-3355
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-242-2450
Provider Business Practice Location Address Fax Number:
336-249-9920
Provider Enumeration Date:
12/17/2008