Provider First Line Business Practice Location Address:
418 N GREEN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORGANTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28655-3209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-438-4941
Provider Business Practice Location Address Fax Number:
828-438-0895
Provider Enumeration Date:
06/12/2006