Provider First Line Business Practice Location Address:
2500 WARREN CARROLL DRIVE
Provider Second Line Business Practice Location Address:
WEISIGER-BROWN ATHLETIC FACILITY
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27695-2769
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-515-2111
Provider Business Practice Location Address Fax Number:
919-513-0728
Provider Enumeration Date:
10/10/2005