Provider First Line Business Practice Location Address:
801 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAURINBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28352-4724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-276-7210
Provider Business Practice Location Address Fax Number:
910-276-2584
Provider Enumeration Date:
09/23/2005