Provider First Line Business Practice Location Address:
300 E HOSPITAL ROAD, BUILDING T-300
Provider Second Line Business Practice Location Address:
EISENHOWER ARMY MED CENTER ORTHOPEDIC SURGERY DEPT
Provider Business Practice Location Address City Name:
FORT GORDON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-787-6157
Provider Business Practice Location Address Fax Number:
706-787-2901
Provider Enumeration Date:
06/28/2006