Provider First Line Business Practice Location Address:
137 MEDICAL LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POLLOCKSVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28573-8200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-633-1010
Provider Business Practice Location Address Fax Number:
252-224-3071
Provider Enumeration Date:
06/22/2006