Provider First Line Business Practice Location Address:
129 E 10TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROANOKE RAPIDS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27870-3818
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-535-7800
Provider Business Practice Location Address Fax Number:
252-586-7744
Provider Enumeration Date:
02/05/2007