Provider First Line Business Practice Location Address:
549TH HOSPITAL CENTER UNIT #15245
Provider Second Line Business Practice Location Address:
FAMILY ADVOCACY PROGRAM - BH
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96251-0078
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-737-5671
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/26/2007