Provider First Line Business Practice Location Address:
3900 BRIDGES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOREHEAD CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28557-2916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-636-6105
Provider Business Practice Location Address Fax Number:
252-636-6109
Provider Enumeration Date:
02/12/2008