Provider First Line Business Practice Location Address:
249 EAST NC 54 HIGHWAY
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-383-8812
Provider Business Practice Location Address Fax Number:
919-383-8904
Provider Enumeration Date:
03/20/2008