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Both are part of McDowell County with Marion being the county seat. Nebo is east of Marion and Old Fort is west.
Of the two, Old Fort would be a better fit. Nebo is unincorporated and has nothing but a Dollar General store. Nebo is 10 minutes from Marion and about 15 from Morganton, which has more options for shopping (Belk, Goody's, Lowe's, Staples).
Old Fort, which doesn't have much more than Nebo (but they're trying), is 10 minutes from Marion and 20 minutes from Asheville. Asheville obviously has the healthcare and shopping you're looking for. Old Fort does have a McDonalds and Hardees.
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