Provider First Line Business Practice Location Address:
800 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALLIANCE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28509-0184
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-745-7196
Provider Business Practice Location Address Fax Number:
252-745-3144
Provider Enumeration Date:
01/16/2007