Provider First Line Business Practice Location Address:
125 W 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28129
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-485-3125
Provider Business Practice Location Address Fax Number:
704-485-2662
Provider Enumeration Date:
02/27/2006