Provider First Line Business Practice Location Address:
115 NORTH DUKE STREET
Provider Second Line Business Practice Location Address:
SUITE 1-B
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-294-6323
Provider Business Practice Location Address Fax Number:
919-286-7703
Provider Enumeration Date:
11/26/2007