Provider First Line Business Practice Location Address:
214 S BARNES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27856-1204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-462-2743
Provider Business Practice Location Address Fax Number:
252-459-8540
Provider Enumeration Date:
04/02/2007