Provider First Line Business Practice Location Address:
426 MCARTHUR DR STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELIZABETH CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27909-4577
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-337-9320
Provider Business Practice Location Address Fax Number:
252-331-1892
Provider Enumeration Date:
06/07/2006