Provider First Line Business Practice Location Address:
628 W INNES ST
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:
28144-4143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-395-0060
Provider Business Practice Location Address Fax Number:
704-521-5092
Provider Enumeration Date:
03/13/2007