Provider First Line Business Practice Location Address:
PSC BOX 20098
Provider Second Line Business Practice Location Address:
HQ AND SERVICE CO, 1ST BN, 6TH MARINE REGT, 2D MARDIV
Provider Business Practice Location Address City Name:
CAMP LEJEUNE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28542-0098
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-450-5150
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/16/2015