Provider First Line Business Practice Location Address:
105 SE RAILROAD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITAKERS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27891-0760
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-437-2171
Provider Business Practice Location Address Fax Number:
252-437-1520
Provider Enumeration Date:
05/11/2007