Provider First Line Business Practice Location Address:
243 CAR FARM RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINCOLNTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28092-7105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-461-4596
Provider Business Practice Location Address Fax Number:
704-735-1226
Provider Enumeration Date:
01/22/2007