Registry details
Type
Individual
Primary specialty
—
Enumerated
Sep 14, 2020
License(s)
5013524 (NC), 5013524 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 190 INDEPENDENCE AVE STE B | North Wilkesboro, NC 28659-4270 | 336-289-2289 |
| MAILING | 645 N MAIN ST | High Point, NC 27260-5017 | 336-883-0029 |
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