Provider First Line Business Practice Location Address:
545 AMITY PARK RD.
Provider Second Line Business Practice Location Address:
MT. VIEW CORRECTIONAL INSTITUTE
Provider Business Practice Location Address City Name:
SPRUCE PINE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28777
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-766-2435
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/13/2012