Provider First Line Business Practice Location Address:
3808 NC HIGHWAY 130 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROWLAND
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28383-8414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-280-7728
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/27/2026