Provider First Line Business Practice Location Address:
1000 S MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 8
Provider Business Practice Location Address City Name:
LAURINBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28352-4764
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-318-1242
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/12/2007