Provider First Line Business Practice Location Address:
121ST COMBAT SUPPORT HOPITAL
Provider Second Line Business Practice Location Address:
BOX 515
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96205
Provider Business Practice Location Address Country Code:
KR
Provider Business Practice Location Address Telephone Number:
01182279173100
Provider Business Practice Location Address Fax Number:
01182279173502
Provider Enumeration Date:
10/12/2006