Provider First Line Business Practice Location Address:
415 S KING ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORGANTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28655-3538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-433-0299
Provider Business Practice Location Address Fax Number:
828-433-0291
Provider Enumeration Date:
03/14/2007