Provider First Line Business Practice Location Address:
117 WARD SPORTS MEDICINE BLDG.
Provider Second Line Business Practice Location Address:
EAST CAROLINA UNIVERSITY
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27858-4353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-737-4603
Provider Business Practice Location Address Fax Number:
252-737-1393
Provider Enumeration Date:
06/27/2006