Provider First Line Business Practice Location Address:
1533 SOUTH MAIN STREET
Provider Second Line Business Practice Location Address:
HEALTH SERVICES
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-519-5554
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/07/2018