Provider First Line Business Practice Location Address:
2228 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TARBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27886-2147
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-823-6622
Provider Business Practice Location Address Fax Number:
252-823-5157
Provider Enumeration Date:
03/09/2007