Provider First Line Business Practice Location Address:
PO DRAWER 12610
Provider Second Line Business Practice Location Address:
2818 NEUSE BLVD.
Provider Business Practice Location Address City Name:
NEW BERN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28561-2610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-636-4920
Provider Business Practice Location Address Fax Number:
252-636-4970
Provider Enumeration Date:
04/16/2007