Provider First Line Business Practice Location Address:
81 NORTH MAIN ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARSHALL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-649-2621
Provider Business Practice Location Address Fax Number:
828-649-3704
Provider Enumeration Date:
06/23/2005