Provider First Line Business Practice Location Address:
1100 E WENDOVER AVE
Provider Second Line Business Practice Location Address:
GCDPH GREENSBORO
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27405-6713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-641-7777
Provider Business Practice Location Address Fax Number:
336-641-6971
Provider Enumeration Date:
06/11/2006