Provider First Line Business Practice Location Address:
127 E TRADE STREET
Provider Second Line Business Practice Location Address:
STE B 100 COMMUNITY CLINIC RUTHERFORD CO
Provider Business Practice Location Address City Name:
FOREST CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28043-3131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-245-0400
Provider Business Practice Location Address Fax Number:
828-247-9000
Provider Enumeration Date:
02/22/2008