Provider First Line Business Practice Location Address:
501 NORTH ELAM AVE
Provider Second Line Business Practice Location Address:
WESLEY LONG HOSPITAL
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-832-1818
Provider Business Practice Location Address Fax Number:
336-832-1917
Provider Enumeration Date:
04/14/2006