Provider First Line Business Practice Location Address:
1690 US HIGHWAY 1 S
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
SOUTHERN PINES
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28387-7037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-684-5499
Provider Business Practice Location Address Fax Number:
910-684-5567
Provider Enumeration Date:
02/15/2006