Provider First Line Business Practice Location Address:
1726 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:
910-484-2284
Provider Business Practice Location Address Fax Number:
910-484-1673
Provider Enumeration Date:
06/10/2011