Provider First Line Business Practice Location Address:
111 S CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27549-2501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-833-3111
Provider Business Practice Location Address Fax Number:
919-834-3118
Provider Enumeration Date:
05/19/2009