Provider First Line Business Practice Location Address:
NAVAL CONSOLIDATED BRIG MIRAMAR
Provider Second Line Business Practice Location Address:
46141 MIRAMAR WAY
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-846-3381
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/25/2013