Provider First Line Business Practice Location Address:
5400 BARBER MILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLAYTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27520-7260
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-553-2238
Provider Business Practice Location Address Fax Number:
919-553-4665
Provider Enumeration Date:
07/24/2006