Provider First Line Business Practice Location Address:
NATIONAL INTREPID CENTER OF EXCELLENCE
Provider Second Line Business Practice Location Address:
3-4303 LONGSTREET RD
Provider Business Practice Location Address City Name:
FORT BRAGG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28310-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-907-6972
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2025