Provider First Line Business Practice Location Address:
255 NC HIGHWAY 16 S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAYLORSVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28681-3048
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
282-632-2271
Provider Business Practice Location Address Fax Number:
828-632-2220
Provider Enumeration Date:
06/09/2009