Provider First Line Business Practice Location Address:
INTERNAL MEDICINE SECTION ON GERONTOLOGY &
Provider Second Line Business Practice Location Address:
1ST FLOOR STICHT CENTER, MEDICAL CENTER BOULEVARD
Provider Business Practice Location Address City Name:
WINSTON SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27157-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-713-8583
Provider Business Practice Location Address Fax Number:
336-716-0427
Provider Enumeration Date:
04/07/2011