Provider First Line Business Practice Location Address:
1170 E MARION 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:
28150-4845
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-487-7221
Provider Business Practice Location Address Fax Number:
704-487-1659
Provider Enumeration Date:
06/30/2016