Provider First Line Business Practice Location Address:
109 MUIRS CHAPEL RD
Provider Second Line Business Practice Location Address:
LOWER LEVEL
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27410-6161
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-852-3300
Provider Business Practice Location Address Fax Number:
336-387-2165
Provider Enumeration Date:
06/09/2005