Provider First Line Business Practice Location Address:
1225 S CALEDONIA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAURINBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28352-4849
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-361-4398
Provider Business Practice Location Address Fax Number:
910-361-4510
Provider Enumeration Date:
12/31/2009