Provider First Line Business Practice Location Address:
400 MILLCREEK RD
Provider Second Line Business Practice Location Address:
HARRIS TEETER #212
Provider Business Practice Location Address City Name:
CARTHAGE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-246-0714
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/04/2013