OUTSIDE REFERRAL
0 min
PLEASE CONTACT PATIENT FOR AN APPOINTMENT
Patient Name: DOB:
Patient Address: 3654 Single Leaf Ct High Point, NC 27265
Patient Phone #: 336-991-6391
Patient Insurance: Medicare - enclosed
Referring Physician: Dr. Clifton Mays, D.C.
Fax #: 336-887-5710
Preferred Physician: Dr. Kenneth Lennon
Reason for Referral: lumbar radiculopathy
REFERRAL COORDINATOR
Areli Hernandez 3755 Admiral Drive Suite 106 High Point, NC 27265
Phone: 336-887-9460 Fax: 336-887-5710