Provider First Line Business Practice Location Address:
114 NURSING HOME RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HERTFORD
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27944-8879
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-848-0294
Provider Business Practice Location Address Fax Number:
434-848-8302
Provider Enumeration Date:
02/27/2007