Provider First Line Business Practice Location Address:
322 S FRANKLIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKY MOUNT
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27804-5711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-446-0027
Provider Business Practice Location Address Fax Number:
252-985-4539
Provider Enumeration Date:
01/11/2011