Provider First Line Business Practice Location Address:
2502 NC HIGHWAY 710
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEMBROKE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28372-7912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-280-3320
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/28/2026