Provider First Line Business Practice Location Address:
4700 US HIGHWAY 117 NORTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PIKEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27863
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-242-2067
Provider Business Practice Location Address Fax Number:
919-242-3715
Provider Enumeration Date:
10/02/2006