Provider First Line Business Practice Location Address:
1700 DOGWOOD MILE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAURINBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28352-5521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-277-5328
Provider Business Practice Location Address Fax Number:
910-277-5020
Provider Enumeration Date:
07/21/2005