Provider First Line Business Practice Location Address:
4300 NORTH CAROLINA HIGHWAY 49
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28075-7527
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-455-6422
Provider Business Practice Location Address Fax Number:
704-454-5124
Provider Enumeration Date:
08/08/2012