Provider First Line Business Practice Location Address:
1 MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUPPLY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28462-3350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-755-1004
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/09/2006