Provider First Line Business Practice Location Address:
113 VIRGINIA RD
Provider Second Line Business Practice Location Address:
VIDANT FAMILY AND SPORTS MEDICINE
Provider Business Practice Location Address City Name:
EDENTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27932
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-482-3047
Provider Business Practice Location Address Fax Number:
252-482-5061
Provider Enumeration Date:
04/29/2016