Provider First Line Business Practice Location Address:
1006 MONROE ST
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:
28327-7387
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-947-2690
Provider Business Practice Location Address Fax Number:
910-947-3878
Provider Enumeration Date:
08/18/2008