Provider First Line Business Practice Location Address:
179 HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRUCE PINE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28777-3035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-955-4023
Provider Business Practice Location Address Fax Number:
719-955-4046
Provider Enumeration Date:
07/12/2005