Provider First Line Business Practice Location Address:
140 MAHALEY AVE STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALISBURY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28144-2449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-637-0150
Provider Business Practice Location Address Fax Number:
980-500-0022
Provider Enumeration Date:
03/12/2026