Provider First Line Business Practice Location Address:
1219 SMOKY PARK HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CANDLER
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28715-9248
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-667-2526
Provider Business Practice Location Address Fax Number:
828-253-4830
Provider Enumeration Date:
05/05/2009