Provider First Line Business Practice Location Address:
810 ARENDELL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOREHEAD CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28557-4235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-499-9598
Provider Business Practice Location Address Fax Number:
828-639-8021
Provider Enumeration Date:
07/01/2005