Provider First Line Business Practice Location Address:
5039 OLD CLINIC BUILDING CLB
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHAPEL HILL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27599-7110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-966-3204
Provider Business Practice Location Address Fax Number:
919-966-3776
Provider Enumeration Date:
06/20/2006