Provider First Line Business Practice Location Address:
MAIN STREET
Provider Second Line Business Practice Location Address:
CAMPBELL UNIVERSITY
Provider Business Practice Location Address City Name:
BUIES CREEK
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-893-1779
Provider Business Practice Location Address Fax Number:
910-814-5567
Provider Enumeration Date:
01/31/2006