Provider First Line Business Practice Location Address:
829 WINGINA AVE
Provider Second Line Business Practice Location Address:
MANTEO HIGH SCHOOL
Provider Business Practice Location Address City Name:
MANTEO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27954-9103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-473-5841
Provider Business Practice Location Address Fax Number:
252-473-2263
Provider Enumeration Date:
02/25/2010