Provider First Line Business Practice Location Address:
109 N CHURCH STREET
Provider Second Line Business Practice Location Address:
PO BOX 98
Provider Business Practice Location Address City Name:
LOUISBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27549-0098
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-477-0008
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/21/2024