Provider First Line Business Practice Location Address:
NAVAL BASE HOSPITAL CENTER MAYPORT
Provider Second Line Business Practice Location Address:
BLDG 2104
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
22228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-270-4210
Provider Business Practice Location Address Fax Number:
904-240-4442
Provider Enumeration Date:
03/21/2006