Provider First Line Business Practice Location Address:
EVANS ARMY MEDICAL CENTER
Provider Second Line Business Practice Location Address:
BLDG 7490 E SUTHERLAND CIR & PROVIDE COMFORT DR
Provider Business Practice Location Address City Name:
FORT CARSON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80913-9500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-526-5815
Provider Business Practice Location Address Fax Number:
719-524-2258
Provider Enumeration Date:
09/09/2005