Provider First Line Business Practice Location Address:
DUKE SOUTH I TRENT DR
Provider Second Line Business Practice Location Address:
CAMPUS BOX 3893
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27710-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-668-1748
Provider Business Practice Location Address Fax Number:
919-681-0874
Provider Enumeration Date:
10/23/2006