Provider First Line Business Practice Location Address:
200 HOSPITAL AVE
Provider Second Line Business Practice Location Address:
SEGRAVES HALL 1
Provider Business Practice Location Address City Name:
JEFFERSON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-264-9664
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/10/2022