Provider First Line Business Practice Location Address:
106 E WATER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLYMOUTH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27962-1330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-793-6500
Provider Business Practice Location Address Fax Number:
252-793-6501
Provider Enumeration Date:
11/09/2011