Provider First Line Business Practice Location Address:
2924 N NC HIGHWAY 16
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILLERS CREEK
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28651-8884
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-838-3145
Provider Business Practice Location Address Fax Number:
336-838-0950
Provider Enumeration Date:
02/01/2007