Provider First Line Business Practice Location Address:
1622 HIGHWAY 52 NORTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBEMARLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28001-9507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-749-2277
Provider Business Practice Location Address Fax Number:
704-749-2278
Provider Enumeration Date:
03/03/2008