Provider First Line Business Practice Location Address:
ABC OF NC
Provider Second Line Business Practice Location Address:
905 FRIEDBERG CHURCH RD
Provider Business Practice Location Address City Name:
WINSTON-SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27127-2712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-251-1180
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/05/2023