Provider First Line Business Practice Location Address:
118 E MORGAN ST # 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WADESBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28170-2202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
980-354-1711
Provider Business Practice Location Address Fax Number:
980-354-1716
Provider Enumeration Date:
01/06/2012