Provider First Line Business Practice Location Address:
5168 NC 66 HWY S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KING
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27021-8132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-830-4885
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/09/2013