Provider First Line Business Practice Location Address:
153 E BELLEVUE DR
Provider Second Line Business Practice Location Address:
ROOMS A, B, & C
Provider Business Practice Location Address City Name:
HIGH POINT
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27265-1922
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-869-1405
Provider Business Practice Location Address Fax Number:
336-841-4810
Provider Enumeration Date:
06/10/2013