Provider First Line Business Practice Location Address:
5100 HWY 70 WEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOREHEAD CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28557-4512
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-727-5290
Provider Business Practice Location Address Fax Number:
252-727-0091
Provider Enumeration Date:
01/27/2006