Provider First Line Business Practice Location Address:
337 RAPIDS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROANOKE RAPIDS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27870-1520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-541-1556
Provider Business Practice Location Address Fax Number:
252-541-1570
Provider Enumeration Date:
01/05/2012