Provider First Line Business Practice Location Address:
4218 ARENDELL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOREHEAD CITY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28557-2866
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-247-3257
Provider Business Practice Location Address Fax Number:
252-247-1076
Provider Enumeration Date:
04/15/2010