Provider First Line Business Practice Location Address:
EASTERN NEPHROLOGY ASSOCIATES PLLC
Provider Second Line Business Practice Location Address:
2021 NORTH POINT BLVD SUITE 106
Provider Business Practice Location Address City Name:
NORTH MYRTLE BEACH
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29582-2224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-663-1401
Provider Business Practice Location Address Fax Number:
910-778-1433
Provider Enumeration Date:
09/08/2005