Provider First Line Business Practice Location Address: 
N CAROLINA CANCER HOSPITAL UNC
    Provider Second Line Business Practice Location Address: 
170 MANNING DR, 3RD FLOOR
    Provider Business Practice Location Address City Name: 
CHAPEL HILL
    Provider Business Practice Location Address State Name: 
NC
    Provider Business Practice Location Address Postal Code: 
27599-0001
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
919-966-7746
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
02/18/2016