Provider First Line Business Practice Location Address:
840 NC HWY 24/27 E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBEMARLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-982-2301
Provider Business Practice Location Address Fax Number:
704-982-2315
Provider Enumeration Date:
10/08/2009