Provider First Line Business Practice Location Address:
DEPARTMENT OF THE ARMY, U.S. ARMY MEDICAL DEPARTMENT
Provider Second Line Business Practice Location Address:
ACTIVITY, FORT DRUM, NEW YORK
Provider Business Practice Location Address City Name:
WATERETOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13602-5004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-772-3314
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2006