Provider First Line Business Practice Location Address:
58TH & 761ST ST TANK BATTALION AVE
Provider Second Line Business Practice Location Address:
THOMAS MOORE HEALTH CLINIC BLDG 2245
Provider Business Practice Location Address City Name:
FORT HOOD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76544
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-288-2621
Provider Business Practice Location Address Fax Number:
254-285-6193
Provider Enumeration Date:
06/15/2006