Provider First Line Business Practice Location Address:
4929 HIGHWAY 226S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAKERSVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-765-0894
Provider Business Practice Location Address Fax Number:
828-765-6257
Provider Enumeration Date:
06/02/2011