Provider First Line Business Practice Location Address:
FORT BLISS MAIN EXCHANGE
Provider Second Line Business Practice Location Address:
BLDG. 1616, STE. F107
Provider Business Practice Location Address City Name:
FORT BLISS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-566-8639
Provider Business Practice Location Address Fax Number:
915-566-8734
Provider Enumeration Date:
10/19/2012