Provider First Line Business Practice Location Address:
2828 MAPLEWOOD AVE STE A
Provider Second Line Business Practice Location Address:
BREAKTHROUGH PHYSICAL THERAPY
Provider Business Practice Location Address City Name:
WINSTON SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27103-4138
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-765-4703
Provider Business Practice Location Address Fax Number:
336-765-1396
Provider Enumeration Date:
06/25/2007