Provider First Line Business Practice Location Address:
3826 NC HWY 49 SOUTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28075-7439
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-787-1807
Provider Business Practice Location Address Fax Number:
704-626-3066
Provider Enumeration Date:
02/19/2013