Provider First Line Business Practice Location Address:
25 MEDICAL CENTER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GATES
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27937-9816
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-357-4337
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/13/2006