Provider First Line Business Practice Location Address:
3004 BRIDGES 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:
28557-3330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-499-2211
Provider Business Practice Location Address Fax Number:
252-727-4936
Provider Enumeration Date:
06/22/2005