Provider First Line Business Practice Location Address:
2541 N.QUEEN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINSTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28501-3851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-527-3636
Provider Business Practice Location Address Fax Number:
252-523-7407
Provider Enumeration Date:
12/21/2011