Provider First Line Business Practice Location Address:
1101 N MORGAN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHELBY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28150-3848
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-482-5396
Provider Business Practice Location Address Fax Number:
704-482-5823
Provider Enumeration Date:
09/25/2006