Provider First Line Business Practice Location Address:
2165 OLD US HIGHWAY 64
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING HOPE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27882-7517
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-478-3958
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/18/2008