Provider First Line Business Practice Location Address:
1015 S CENTENNIAL ST
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:
27260-7850
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-660-2030
Provider Business Practice Location Address Fax Number:
888-812-7944
Provider Enumeration Date:
12/27/2006