Provider First Line Business Practice Location Address: 
101 E ATKINS ST
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
DOBSON
    Provider Business Practice Location Address State Name: 
NC
    Provider Business Practice Location Address Postal Code: 
27017-8700
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
336-386-4168
    Provider Business Practice Location Address Fax Number: 
336-386-4870
    Provider Enumeration Date: 
09/17/2009