Provider First Line Business Practice Location Address:
1816 MARTIN LUTHER KING JR. BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHAPEL HILL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-969-9667
Provider Business Practice Location Address Fax Number:
919-969-9774
Provider Enumeration Date:
05/16/2008