Provider First Line Business Practice Location Address:
106 MEDICAL DRIVE
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-338-3002
Provider Business Practice Location Address Fax Number:
252-338-2902
Provider Enumeration Date:
03/14/2006