Provider First Line Business Practice Location Address:
BAACH, 121 CSH
Provider Second Line Business Practice Location Address:
OTOLARYNGOLOGY SECTION
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-737-1285
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/26/2007