Provider First Line Business Practice Location Address:
2850 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIGH POINT
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27263-2183
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-434-3149
Provider Business Practice Location Address Fax Number:
336-434-5378
Provider Enumeration Date:
07/16/2012