Provider First Line Business Practice Location Address:
808 W EHRINGHAUS STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELIZABETH CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-338-3206
Provider Business Practice Location Address Fax Number:
252-338-6394
Provider Enumeration Date:
08/31/2006