Provider First Line Business Practice Location Address:
228B MORGANTON BLVD SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LENOIR
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28645-5219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-754-8181
Provider Business Practice Location Address Fax Number:
828-754-8140
Provider Enumeration Date:
11/21/2006