Provider First Line Business Practice Location Address:
300 HWY 24
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:
28557-2551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-247-5489
Provider Business Practice Location Address Fax Number:
252-247-5823
Provider Enumeration Date:
11/12/2007