Provider First Line Business Practice Location Address:
1112 ATKINSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAURINBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28352-4723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-277-2563
Provider Business Practice Location Address Fax Number:
910-277-2564
Provider Enumeration Date:
02/05/2007