Provider First Line Business Practice Location Address:
2400 PRATT ST
Provider Second Line Business Practice Location Address:
RM 0311 TERRACE LEVEL
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27705-3976
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-668-8871
Provider Business Practice Location Address Fax Number:
919-668-7056
Provider Enumeration Date:
05/04/2006