Provider First Line Business Practice Location Address:
5000 LAMB'S PATH WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CASTLE HAYNE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28404-0399
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-675-3533
Provider Business Practice Location Address Fax Number:
910-675-3533
Provider Enumeration Date:
12/23/2008