Provider First Line Business Practice Location Address:
125 W CATAWBA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT HOLLY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28120-1601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-827-3014
Provider Business Practice Location Address Fax Number:
704-822-9114
Provider Enumeration Date:
08/22/2005