Provider First Line Business Practice Location Address:
1300 N UNIVERSITY PKWY
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:
27262-3456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-841-4683
Provider Business Practice Location Address Fax Number:
336-888-6353
Provider Enumeration Date:
09/29/2010