Provider First Line Business Practice Location Address:
5034 OLD CLINIC BLDG
Provider Second Line Business Practice Location Address:
CB #7110
Provider Business Practice Location Address City Name:
CHAPEL HILL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27599-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-966-3204
Provider Business Practice Location Address Fax Number:
919-966-3776
Provider Enumeration Date:
06/15/2006