Provider First Line Business Practice Location Address:
819 W. KNOX ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-304-2888
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/26/2008