Provider First Line Business Practice Location Address:
BLDG. 277 CODE 100D
Provider Second Line Business Practice Location Address:
NAVAL MEDICAL CENTER PORTSMOUTH - N
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-953-6509
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/27/2006