Provider First Line Business Practice Location Address:
607 BEAMAN ST
Provider Second Line Business Practice Location Address:
ANESTHESIA DEPARTMENT
Provider Business Practice Location Address City Name:
CLINTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28328-2603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-590-8729
Provider Business Practice Location Address Fax Number:
910-590-2321
Provider Enumeration Date:
11/17/2006