Provider First Line Business Practice Location Address:
2675 LONG FERRY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALISBURY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28146-8446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-647-7736
Provider Business Practice Location Address Fax Number:
704-937-1016
Provider Enumeration Date:
02/02/2026