Provider First Line Business Practice Location Address:
DEPT. PSYCHIATRY, 67TH CSH UNIT 26610
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
3503651
Provider Business Practice Location Address Fax Number:
3503242
Provider Enumeration Date:
10/14/2005