Provider First Line Business Practice Location Address:
201 W MORGAN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WADESBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28170-2683
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-465-2350
Provider Business Practice Location Address Fax Number:
704-465-2351
Provider Enumeration Date:
09/03/2009