Provider First Line Business Practice Location Address:
118 JAMES ST.
Provider Second Line Business Practice Location Address:
SUITE P
Provider Business Practice Location Address City Name:
LAURINBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28352-8810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-506-4644
Provider Business Practice Location Address Fax Number:
910-506-4876
Provider Enumeration Date:
12/01/2009