Provider First Line Business Practice Location Address:
501 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27549-2335
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-497-3435
Provider Business Practice Location Address Fax Number:
919-496-7330
Provider Enumeration Date:
07/08/2009