Provider First Line Business Practice Location Address:
56 N HIGHLAND AVE
Provider Second Line Business Practice Location Address:
DBA BROCKFORD INN INC
Provider Business Practice Location Address City Name:
GRANITE FALLS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28630-1205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-396-3111
Provider Business Practice Location Address Fax Number:
828-396-5822
Provider Enumeration Date:
09/25/2006