Provider First Line Business Practice Location Address:
3610 MEDICAL PARK COURT
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-808-3376
Provider Business Practice Location Address Fax Number:
252-808-2095
Provider Enumeration Date:
01/23/2007