Provider First Line Business Practice Location Address:
201 E PITT ST
Provider Second Line Business Practice Location Address:
STE 207-208 (EDGECOMBE PROF. BLDG)
Provider Business Practice Location Address City Name:
TARBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27886-5192
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-491-3299
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/03/2010