Provider First Line Business Practice Location Address: 
207 OLD LEXINGTON RD
    Provider Second Line Business Practice Location Address: 
EMERGENCY DEPARTMENT
    Provider Business Practice Location Address City Name: 
THOMASVILLE
    Provider Business Practice Location Address State Name: 
NC
    Provider Business Practice Location Address Postal Code: 
27360-3428
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
336-476-2526
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
10/24/2006