Provider First Line Business Practice Location Address:
13681 HWY 226 SOUTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRUCE PINE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28777
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-766-7771
Provider Business Practice Location Address Fax Number:
828-766-5862
Provider Enumeration Date:
05/31/2012