Provider First Line Business Practice Location Address:
VAMC 1500 E. WOODROW WILSON
Provider Second Line Business Practice Location Address:
AUDIOLOGY SERVICE
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-362-4471
Provider Business Practice Location Address Fax Number:
601-368-4140
Provider Enumeration Date:
10/03/2006