Provider First Line Business Practice Location Address:
617 EAST KING STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KING
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27021-0824
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-983-2210
Provider Business Practice Location Address Fax Number:
336-983-2218
Provider Enumeration Date:
02/07/2007