Provider First Line Business Practice Location Address:
2362 HWY 130 WEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROWLAND
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28383
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-422-8811
Provider Business Practice Location Address Fax Number:
910-422-8046
Provider Enumeration Date:
09/07/2005