Provider First Line Business Practice Location Address:
140 NC HWY 102 WEST
Provider Second Line Business Practice Location Address:
KERR DRUG #500
Provider Business Practice Location Address City Name:
AYDEN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-746-3926
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/15/2010