Provider First Line Business Practice Location Address:
KIMBROUGH AMBULATORY CARE CENTER
Provider Second Line Business Practice Location Address:
LLEWELYN
Provider Business Practice Location Address City Name:
FT MEADE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20755
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-677-8716
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/22/2005