Provider First Line Business Practice Location Address:
201 W EDGECOMBE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MACCLESFIELD
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27852
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-827-5231
Provider Business Practice Location Address Fax Number:
252-827-5775
Provider Enumeration Date:
08/11/2005