Provider First Line Business Practice Location Address: 
600 HOSPITAL DR
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
MONROE
    Provider Business Practice Location Address State Name: 
NC
    Provider Business Practice Location Address Postal Code: 
28112-6000
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
704-993-2240
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
09/09/2014