Provider First Line Business Practice Location Address:
USS ABRAHAM LINCOLN
Provider Second Line Business Practice Location Address:
CVN 72 UNIT 100349 #1 DIVISION MEDICAL
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-545-1148
Provider Business Practice Location Address Fax Number:
808-353-8005
Provider Enumeration Date:
04/04/2007