Provider First Line Business Practice Location Address:
2498 US HIGHWAY 74 E
Provider Second Line Business Practice Location Address:
2498 US HIGHWAY 74 EAST
Provider Business Practice Location Address City Name:
WADESBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28170-6479
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-994-3606
Provider Business Practice Location Address Fax Number:
866-861-5406
Provider Enumeration Date:
04/18/2007