Provider First Line Business Practice Location Address:
301 ANDREW AVE
Provider Second Line Business Practice Location Address:
LYSTER ARMY HEALTH CLINIC
Provider Business Practice Location Address City Name:
FORT RUCKER
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36360-5001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-255-7260
Provider Business Practice Location Address Fax Number:
334-255-7663
Provider Enumeration Date:
09/11/2008