Provider First Line Business Practice Location Address:
COASTAL EYE CENTER
Provider Second Line Business Practice Location Address:
1855 WEST CITY DRIVE
Provider Business Practice Location Address City Name:
ELIZABETH CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-338-3909
Provider Business Practice Location Address Fax Number:
252-331-1213
Provider Enumeration Date:
09/19/2006