Provider First Line Business Practice Location Address:
5620 NC HIGHWAY 55 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COVE CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28523-9434
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-787-5393
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/27/2025