Provider First Line Business Practice Location Address:
823 E. KING STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINGS MOUNTAIN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28086-3186
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
980-487-2700
Provider Business Practice Location Address Fax Number:
980-487-2701
Provider Enumeration Date:
10/14/2011