Provider First Line Business Practice Location Address:
1434 PORTER STREET
Provider Second Line Business Practice Location Address:
BARQUIST ARMY HEALTH CARE FACILITY
Provider Business Practice Location Address City Name:
FREDERICK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-319-7208
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/07/2006