Provider First Line Business Practice Location Address:
USS EMORY S. LAND (AS 39)
Provider Second Line Business Practice Location Address:
UNIT 100104 BOX MEDICAL
Provider Business Practice Location Address City Name:
FPO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96667-0400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
671-343-1124
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/07/2022