Provider First Line Business Practice Location Address:
5200 N CROATAN HWY
Provider Second Line Business Practice Location Address:
BEACH MEDICAL CARE, LTD.
Provider Business Practice Location Address City Name:
KITTY HAWK
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27949
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-261-4187
Provider Business Practice Location Address Fax Number:
252-261-5182
Provider Enumeration Date:
02/05/2007