Provider First Line Business Practice Location Address:
216 UNION CHURCH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARTHAGE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28327-0224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-585-1912
Provider Business Practice Location Address Fax Number:
910-947-3951
Provider Enumeration Date:
02/13/2007