Provider First Line Business Practice Location Address:
4959 NC HWY 49 SOUTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28075
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
980-258-8992
Provider Business Practice Location Address Fax Number:
704-919-5638
Provider Enumeration Date:
11/16/2021