Provider First Line Business Practice Location Address:
48 HOSPITAL DR
Provider Second Line Business Practice Location Address:
SUITE 2-A
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28722-8516
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-894-3718
Provider Business Practice Location Address Fax Number:
828-894-3806
Provider Enumeration Date:
02/22/2006