Provider First Line Business Practice Location Address:
2302 NC 56 HWY E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27549-6939
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-727-2744
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/01/2026