Provider First Line Business Practice Location Address:
145 W PARKER RD STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORGANTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28655-4649
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-433-5177
Provider Business Practice Location Address Fax Number:
828-433-1127
Provider Enumeration Date:
03/14/2007