Provider First Line Business Practice Location Address:
5296 B BADGER LANE
Provider Second Line Business Practice Location Address:
USA MEDDAC ARMY COMMUNITY HOSPITAL BUILDING 166
Provider Business Practice Location Address City Name:
FT IRWIN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-380-3144
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/05/2006