Provider First Line Business Practice Location Address:
MEDICAL CENTER BOULEVARD
Provider Second Line Business Practice Location Address:
DEPARTMENT OF RADIOLOGY, WAKE FOREST SCHOOL OF MEDICINE
Provider Business Practice Location Address City Name:
WINSTON-SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27157-1088
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-716-2471
Provider Business Practice Location Address Fax Number:
336-716-0555
Provider Enumeration Date:
05/24/2017