Provider First Line Business Practice Location Address:
1295 OLD US 1 HWY STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTHERN PINES
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28387-6344
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-215-0950
Provider Business Practice Location Address Fax Number:
910-215-0940
Provider Enumeration Date:
07/17/2020