Provider First Line Business Practice Location Address:
RALPH H JOHNSON VA MEDICAL CENTER
Provider Second Line Business Practice Location Address:
109 BEE STREET
Provider Business Practice Location Address City Name:
CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29401-5799
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-789-6583
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/20/2007