Provider First Line Business Practice Location Address:
BAMC
Provider Second Line Business Practice Location Address:
3551 ROGER BROOKE DR.
Provider Business Practice Location Address City Name:
FORT SAM HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-390-9165
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/02/2006