Provider First Line Business Practice Location Address:
1104 ARENDELL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOREHEAD CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28557-4144
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-725-0480
Provider Business Practice Location Address Fax Number:
252-222-3100
Provider Enumeration Date:
07/11/2006