Provider First Line Business Practice Location Address:
8282 SOUTH NC 58 HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELM CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27822
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-443-7744
Provider Business Practice Location Address Fax Number:
252-443-7611
Provider Enumeration Date:
03/06/2007