Provider First Line Business Practice Location Address:
131 BYNUM'S PLACE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORLINA
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27563-9139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-257-0149
Provider Business Practice Location Address Fax Number:
252-257-2307
Provider Enumeration Date:
02/13/2007