Provider First Line Business Practice Location Address:
2636 DR MARTIN LUTHER KING JR BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BERN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28562-4238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-636-1919
Provider Business Practice Location Address Fax Number:
252-636-2656
Provider Enumeration Date:
02/23/2006