Provider First Line Business Practice Location Address:
1750 METROMEDICAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28304-3861
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-485-8831
Provider Business Practice Location Address Fax Number:
910-485-8832
Provider Enumeration Date:
10/13/2006