Provider First Line Business Practice Location Address:
101 W EHRINGHAUS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELIZABETH CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27909-4921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-338-3933
Provider Business Practice Location Address Fax Number:
252-338-1760
Provider Enumeration Date:
10/16/2012