Provider First Line Business Practice Location Address:
418 KING STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAURINBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28352
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-276-7570
Provider Business Practice Location Address Fax Number:
910-276-1327
Provider Enumeration Date:
11/22/2005