Provider First Line Business Practice Location Address:
308 S ACADEMY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINCOLNTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28092-2717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-736-9188
Provider Business Practice Location Address Fax Number:
704-736-9667
Provider Enumeration Date:
07/06/2006