Provider First Line Business Practice Location Address:
716 WASHINGTON STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLYMOUTH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27962-2222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-946-0585
Provider Business Practice Location Address Fax Number:
252-946-0580
Provider Enumeration Date:
08/22/2011