Provider First Line Business Practice Location Address:
115 NORTH DUKE STREET
Provider Second Line Business Practice Location Address:
SUITE 1-B
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27701-2010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-286-3453
Provider Business Practice Location Address Fax Number:
919-286-7033
Provider Enumeration Date:
06/26/2006