Provider First Line Business Practice Location Address:
503 CARTHAGE ST.
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
SANFORD
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-775-5549
Provider Business Practice Location Address Fax Number:
919-775-7482
Provider Enumeration Date:
08/27/2006