Provider First Line Business Practice Location Address:
2301 US HIGHWAY 74 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WADESBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28170-7554
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-994-4900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/01/2005