Provider First Line Business Practice Location Address:
115 ADAMS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLYMOUTH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27962-1307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-741-3413
Provider Business Practice Location Address Fax Number:
252-214-6662
Provider Enumeration Date:
08/20/2024