Provider First Line Business Practice Location Address:
525 ATKINSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAURINBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28352-3715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-276-0766
Provider Business Practice Location Address Fax Number:
910-277-6295
Provider Enumeration Date:
10/20/2006