Provider First Line Business Practice Location Address:
4512 WADE STEDMAN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WADE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28395-8548
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-885-8830
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/14/2026