Provider First Line Business Practice Location Address:
1423 MARSHALL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROANOKE RAPIDS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27870-4413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-541-1235
Provider Business Practice Location Address Fax Number:
252-541-1111
Provider Enumeration Date:
10/20/2022