Provider First Line Business Practice Location Address:
260 ALBEMARLE AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKY MOUNT
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-316-8215
Provider Business Practice Location Address Fax Number:
252-822-5065
Provider Enumeration Date:
06/05/2018