Provider First Line Business Practice Location Address:
144 COMMUNITY COLLEGE RD STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AHOSKIE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27910-8047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-209-8932
Provider Business Practice Location Address Fax Number:
252-332-2483
Provider Enumeration Date:
12/17/2012