Provider First Line Business Practice Location Address:
1742 METROMEDICAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28304-3861
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-401-0121
Provider Business Practice Location Address Fax Number:
910-263-8975
Provider Enumeration Date:
11/12/2009