Provider First Line Business Practice Location Address:
2183 JAMES B WHITE HWY N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28472-8989
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-641-0011
Provider Business Practice Location Address Fax Number:
910-641-0083
Provider Enumeration Date:
05/16/2006