Provider First Line Business Practice Location Address:
101 CLINIC DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TARBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27886-1935
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-823-7288
Provider Business Practice Location Address Fax Number:
252-824-1409
Provider Enumeration Date:
07/23/2007