Provider First Line Business Practice Location Address:
USA MEDDAC, EVANS ARMY COMMUNITY HOSPTIAL
Provider Second Line Business Practice Location Address:
1650 COCHRANE CIRCLE: ATTN: NUTRITION CARE DIVISION
Provider Business Practice Location Address City Name:
FORT CARSON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80913-4604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-526-7968
Provider Business Practice Location Address Fax Number:
719-526-7586
Provider Enumeration Date:
03/15/2006