Provider First Line Business Practice Location Address:
27 W MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMLET
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28345
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-582-3585
Provider Business Practice Location Address Fax Number:
910-582-3586
Provider Enumeration Date:
08/19/2005