Provider First Line Business Practice Location Address:
496 ALTAPASS HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRUCE PINE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28777
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-765-0170
Provider Business Practice Location Address Fax Number:
828-765-5877
Provider Enumeration Date:
06/27/2006