Provider First Line Business Practice Location Address: 
1010 COLLEGE ST
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
OXFORD
    Provider Business Practice Location Address State Name: 
NC
    Provider Business Practice Location Address Postal Code: 
27565-2507
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
919-690-3000
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
05/10/2013