Provider First Line Business Practice Location Address:
1603 MEDICAL DR STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAURINBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28352-5541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-276-7011
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/04/2007