Provider First Line Business Practice Location Address:
2170 MIDLAND RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTHERN PINES
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28387-2927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-295-2100
Provider Business Practice Location Address Fax Number:
910-295-5339
Provider Enumeration Date:
03/13/2007