Provider First Line Business Practice Location Address:
HHC XVIII AIRBORNE CORPS SURGEON OFFICE
Provider Second Line Business Practice Location Address:
MACOMB STREET, BLDG 2-1148
Provider Business Practice Location Address City Name:
FORT BRAGG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28310-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-396-5772
Provider Business Practice Location Address Fax Number:
910-396-2874
Provider Enumeration Date:
11/03/2005