Provider First Line Business Practice Location Address:
663 MOULTON RD
Provider Second Line Business Practice Location Address:
FRANKLIN COUNTY GROUP HOME #1
Provider Business Practice Location Address City Name:
LOUISBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27549-7753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-438-6700
Provider Business Practice Location Address Fax Number:
252-438-6720
Provider Enumeration Date:
01/23/2007