Provider First Line Business Practice Location Address:
4251 ARENDELL STREET
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
MOREHEAD CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28557-2871
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-808-3100
Provider Business Practice Location Address Fax Number:
252-808-3120
Provider Enumeration Date:
04/27/2006