Provider First Line Business Practice Location Address:
416 WEST WARREN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHELBY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-482-3281
Provider Business Practice Location Address Fax Number:
704-484-2990
Provider Enumeration Date:
08/01/2006