Provider First Line Business Practice Location Address:
400 E COMMERCE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIGH POINT
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27260-5221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-884-0224
Provider Business Practice Location Address Fax Number:
336-884-3471
Provider Enumeration Date:
07/14/2005