Provider First Line Business Practice Location Address:
1319 S. GLENBURNIE BLVD. SUITE D
Provider Second Line Business Practice Location Address:
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:
252-635-1699
Provider Business Practice Location Address Fax Number:
252-635-9599
Provider Enumeration Date:
01/10/2007