Provider First Line Business Practice Location Address:
2485 HWY 74 WEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WADESBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28170
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-694-2596
Provider Business Practice Location Address Fax Number:
704-694-2795
Provider Enumeration Date:
10/10/2012