Provider First Line Business Practice Location Address:
704-K PLAZA BLVD
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:
28501-1567
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-527-2106
Provider Business Practice Location Address Fax Number:
252-527-1217
Provider Enumeration Date:
07/28/2005