Provider First Line Business Practice Location Address:
110 W. SECOND ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENLY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-284-2010
Provider Business Practice Location Address Fax Number:
919-284-2231
Provider Enumeration Date:
01/19/2007