Provider First Line Business Practice Location Address:
2605 RAEFORD RD
Provider Second Line Business Practice Location Address:
RTIE AID PHARMACY-11503
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-484-2170
Provider Business Practice Location Address Fax Number:
910-321-9578
Provider Enumeration Date:
06/29/2010