Provider First Line Business Practice Location Address:
1801 MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TARBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27886
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-823-5444
Provider Business Practice Location Address Fax Number:
252-823-4370
Provider Enumeration Date:
03/30/2007