Provider First Line Business Practice Location Address:
USA MEDDAC
Provider Second Line Business Practice Location Address:
DR. MARY E. WALKER CENTER BUILDING 170
Provider Business Practice Location Address City Name:
FORT IRWIN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-380-3631
Provider Business Practice Location Address Fax Number:
760-380-6469
Provider Enumeration Date:
04/27/2006