Provider First Line Business Practice Location Address:
700 EAST PARKER ROAD
Provider Second Line Business Practice Location Address:
PO DRAWER 989
Provider Business Practice Location Address City Name:
MORGANTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28655-4647
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-439-4332
Provider Business Practice Location Address Fax Number:
828-439-4314
Provider Enumeration Date:
08/24/2011