Provider First Line Business Practice Location Address:
NAVAL HOSPITAL
Provider Second Line Business Practice Location Address:
ATTN PROFESSIONAL AFFAIRS MAGTFTC MCAGCC
Provider Business Practice Location Address City Name:
TWENTYNINE PALMS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92278-8250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-830-2670
Provider Business Practice Location Address Fax Number:
760-830-2131
Provider Enumeration Date:
01/26/2006