Provider First Line Business Practice Location Address:
147 E ACADEMY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASHEBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27203-5706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-633-1212
Provider Business Practice Location Address Fax Number:
336-633-1218
Provider Enumeration Date:
11/29/2005