Provider First Line Business Practice Location Address:
DUKE HOSPITAL SOUTH 3RD FLOOR BLUE ZONE ROOM 3532
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27710-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-613-4573
Provider Business Practice Location Address Fax Number:
919-613-4581
Provider Enumeration Date:
03/29/2013