Provider First Line Business Practice Location Address:
OIC, PHYSICAL EXAM SECTION, MARTIN ARMY COMM HOSP
Provider Second Line Business Practice Location Address:
BLDG 9224 MCXB-F-PES
Provider Business Practice Location Address City Name:
FORT BENNING
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31905-6100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-544-5172
Provider Business Practice Location Address Fax Number:
706-544-5104
Provider Enumeration Date:
08/31/2005