Provider First Line Business Practice Location Address:
1502 E FRANKLIN ST
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
CHAPEL HILL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27514-2884
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-942-8880
Provider Business Practice Location Address Fax Number:
919-942-5961
Provider Enumeration Date:
09/16/2006