Provider First Line Business Practice Location Address:
2 W BLISS ARMY HEALTH CTR
Provider Second Line Business Practice Location Address:
BLDG 45001
Provider Business Practice Location Address City Name:
FT HUACHUCA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-533-2520
Provider Business Practice Location Address Fax Number:
520-533-0464
Provider Enumeration Date:
09/22/2006