Provider First Line Business Practice Location Address:
HWY 264 ALTERNATE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAILEY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27807-0550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-235-4557
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/31/2008