Provider First Line Business Practice Location Address:
2117 SOUTH GLENBURNIE ROAD
Provider Second Line Business Practice Location Address:
STE 9 & 10
Provider Business Practice Location Address City Name:
NEW BERN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28562-2239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-636-1001
Provider Business Practice Location Address Fax Number:
252-636-1188
Provider Enumeration Date:
12/11/2006