Provider First Line Business Practice Location Address:
3800 HIGHWAY 49 S
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:
28075-7522
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-455-2999
Provider Business Practice Location Address Fax Number:
704-455-1624
Provider Enumeration Date:
04/20/2006