Provider First Line Business Practice Location Address:
2602 DR M L KING JR BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BERN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28562-4238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-514-0374
Provider Business Practice Location Address Fax Number:
252-514-2324
Provider Enumeration Date:
07/24/2006