Provider First Line Business Practice Location Address:
1442 16TH STREET
Provider Second Line Business Practice Location Address:
MEDICAL TASK FORCE SHELBY
Provider Business Practice Location Address City Name:
CAMP SHELBY
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-558-4772
Provider Business Practice Location Address Fax Number:
601-558-2226
Provider Enumeration Date:
03/07/2007