Provider First Line Business Practice Location Address:
5500 HIGHWAY 49 S
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28075-8414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-455-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/22/2008