Provider First Line Business Practice Location Address:
1135 AHOSKIE COFIELD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COFIELD
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27922-9540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-358-6861
Provider Business Practice Location Address Fax Number:
252-358-6861
Provider Enumeration Date:
04/22/2008