Provider First Line Business Practice Location Address:
200 SOUTH 5TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEBANE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27302-2730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-563-2990
Provider Business Practice Location Address Fax Number:
919-563-3010
Provider Enumeration Date:
09/28/2006