Provider First Line Business Practice Location Address:
1246 WEEKSVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELIZABETH CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27909-8408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-331-1720
Provider Business Practice Location Address Fax Number:
252-330-8030
Provider Enumeration Date:
07/22/2013