Provider First Line Business Practice Location Address:
COMMANDER, USA MEDCOM
Provider Second Line Business Practice Location Address:
2050 WORTH ROAD, SUITE 10, ATTN: MCHO-CL-H
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78234-6010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-221-6499
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/10/2005