Provider First Line Business Practice Location Address:
2203 NEUSE BOULEVARD
Provider Second Line Business Practice Location Address:
COASTAL SURGICAL SPECIALISTS, PA
Provider Business Practice Location Address City Name:
NEW BERN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28560-4311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-638-8118
Provider Business Practice Location Address Fax Number:
252-638-5192
Provider Enumeration Date:
08/28/2008