Provider First Line Business Practice Location Address:
FORT CARSON MEDDAC
Provider Second Line Business Practice Location Address:
1650 COCHRANE CIRCLE
Provider Business Practice Location Address City Name:
FORT CARSON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-526-7653
Provider Business Practice Location Address Fax Number:
719-526-7673
Provider Enumeration Date:
03/21/2006