Provider First Line Business Practice Location Address:
1801 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TARBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27886-2525
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-823-5444
Provider Business Practice Location Address Fax Number:
252-823-7340
Provider Enumeration Date:
04/30/2008