Provider First Line Business Practice Location Address:
1124 E LEXINGTON AVE
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:
27262-3336
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-841-6083
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/14/2009