Provider First Line Business Practice Location Address:
4110 DOCTOR MARTIN LUTHER KING JR BLVD
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
NEW BERN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28562
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-638-1312
Provider Business Practice Location Address Fax Number:
252-631-1859
Provider Enumeration Date:
03/08/2013