Provider First Line Business Practice Location Address:
102 HIGHLAND AVE, S.E. SUITE 455
Provider Second Line Business Practice Location Address:
COMMUNITY MEDICAL BUILDING, PRENATAL DIAGNOSTIC CENTER
Provider Business Practice Location Address City Name:
ROANOKE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24013-2256
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-224-6934
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/05/2007