Provider First Line Business Practice Location Address:
3415B MELROSE ROAD
Provider Second Line Business Practice Location Address:
PRIME PEDIATRICS
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-437-9600
Provider Business Practice Location Address Fax Number:
910-437-9801
Provider Enumeration Date:
01/30/2006