Provider First Line Business Practice Location Address:
1269 APPLE TREE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STANTONSBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27883-9039
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-747-4000
Provider Business Practice Location Address Fax Number:
252-747-2602
Provider Enumeration Date:
03/06/2007