Provider First Line Business Practice Location Address: 
1638 OWEN DRIVE
    Provider Second Line Business Practice Location Address: 
CAPE FEAR VALLEY MEDICAL CENTER EMERGENCY DEPARTMENT
    Provider Business Practice Location Address City Name: 
FAYETTEVILLE
    Provider Business Practice Location Address State Name: 
NC
    Provider Business Practice Location Address Postal Code: 
28314-2000
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
910-615-8000
    Provider Business Practice Location Address Fax Number: 
910-321-6250
    Provider Enumeration Date: 
08/17/2011