Provider First Line Business Practice Location Address:
84 MEDICAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANGIER
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27501-6087
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-639-2122
Provider Business Practice Location Address Fax Number:
919-639-8685
Provider Enumeration Date:
01/16/2007