Provider First Line Business Practice Location Address:
730 ROANOKE AVENUE
Provider Second Line Business Practice Location Address:
STE A3
Provider Business Practice Location Address City Name:
ROANOKE RAPIDS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27870
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-541-1800
Provider Business Practice Location Address Fax Number:
252-410-0544
Provider Enumeration Date:
08/25/2009