Provider First Line Business Practice Location Address:
119 S. 4TH ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIGHLANDS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28741-0908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-526-8885
Provider Business Practice Location Address Fax Number:
828-526-8885
Provider Enumeration Date:
03/10/2008