Provider First Line Business Practice Location Address:
125 MEDICAL PARK LN
Provider Second Line Business Practice Location Address:
SUITE F
Provider Business Practice Location Address City Name:
MURPHY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28906-6920
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-837-4201
Provider Business Practice Location Address Fax Number:
828-837-9359
Provider Enumeration Date:
11/09/2005