Provider First Line Business Practice Location Address:
416 FAIRLEY ST
Provider Second Line Business Practice Location Address:
SUITE E
Provider Business Practice Location Address City Name:
LAURINBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28352-3612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-276-8545
Provider Business Practice Location Address Fax Number:
910-276-8587
Provider Enumeration Date:
08/04/2009