Provider First Line Business Practice Location Address:
5039 OLD CLINIC BLDG
Provider Second Line Business Practice Location Address:
CB # 7110
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:
919-843-0391
Provider Business Practice Location Address Fax Number:
919-966-4507
Provider Enumeration Date:
09/01/2006