Provider First Line Business Practice Location Address:
205 N 19TH 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:
28557-3601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-422-5584
Provider Business Practice Location Address Fax Number:
252-247-2911
Provider Enumeration Date:
01/06/2007