Provider First Line Business Practice Location Address:
3500 ARENDELL ST
Provider Second Line Business Practice Location Address:
PO DRAWER 1619
Provider Business Practice Location Address City Name:
MOREHEAD CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28557-2901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-808-6177
Provider Business Practice Location Address Fax Number:
252-808-6637
Provider Enumeration Date:
05/28/2008