Provider First Line Business Practice Location Address:
1185A HOUPT PHYSICIAN OFFICE BLDG.
Provider Second Line Business Practice Location Address:
CB# 7236 170 MANNING DRIVE
Provider Business Practice Location Address City Name:
CHAPEL HILL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27599-7236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-966-1178
Provider Business Practice Location Address Fax Number:
919-966-7629
Provider Enumeration Date:
09/07/2015