Provider First Line Business Practice Location Address:
1140 HOLLY SPRINGS RD
Provider Second Line Business Practice Location Address:
SUITE #207
Provider Business Practice Location Address City Name:
HOLLY SPRINGS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-557-6111
Provider Business Practice Location Address Fax Number:
919-567-9920
Provider Enumeration Date:
01/17/2008