Provider First Line Business Practice Location Address: 
101 MANNING DR
    Provider Second Line Business Practice Location Address: 
OUTPATIENT CLINICAL NUTRITION DEPARTMENT
    Provider Business Practice Location Address City Name: 
CHAPEL HILL
    Provider Business Practice Location Address State Name: 
NC
    Provider Business Practice Location Address Postal Code: 
27514-4220
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
984-974-3357
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
09/09/2014