Provider First Line Business Practice Location Address:
1307 MARKET ST
Provider Second Line Business Practice Location Address:
NEW HANOVER HIGH SCHOOL
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28401-4331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-790-9949
Provider Business Practice Location Address Fax Number:
910-763-4990
Provider Enumeration Date:
05/31/2016