Provider First Line Business Practice Location Address:
1829 EAST FRANKLIN ST.
Provider Second Line Business Practice Location Address:
SUITE 700B
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-967-4171
Provider Business Practice Location Address Fax Number:
919-967-4173
Provider Enumeration Date:
10/25/2006