Provider First Line Business Practice Location Address:
100 MANNING DR
Provider Second Line Business Practice Location Address:
C/O CLINICAL CARE MANAGEMENT
Provider Business Practice Location Address City Name:
CHAPEL HILL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27599-6117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-966-0230
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/30/2008