Provider First Line Business Practice Location Address:
101 MANNING DR
Provider Second Line Business Practice Location Address:
3RD FLOOR WOMEN'S & CHILDREN'S HOSP, ROOM 30149
Provider Business Practice Location Address City Name:
CHAPEL HILL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27514-4220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-843-1476
Provider Business Practice Location Address Fax Number:
919-966-6417
Provider Enumeration Date:
06/19/2008