Provider First Line Business Practice Location Address:
1766 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:
910-222-2202
Provider Business Practice Location Address Fax Number:
910-222-2201
Provider Enumeration Date:
07/24/2006