Provider First Line Business Practice Location Address:
MISAWA AIR BASE
Provider Second Line Business Practice Location Address:
BUILDING 99, 35TH MED GROUP
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96319
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-226-6140
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/17/2014