Provider First Line Business Practice Location Address:
16860 NC HIGHWAY 87 E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COUNCIL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28434-8738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-669-2226
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/19/2007