Provider First Line Business Practice Location Address:
633 OLD LANDFILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAYLORSVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28681-8420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-632-1331
Provider Business Practice Location Address Fax Number:
828-632-1346
Provider Enumeration Date:
11/02/2006