Provider First Line Business Practice Location Address:
VA MEDICAL CENTER (119)
Provider Second Line Business Practice Location Address:
7305 N. MILITARY TRAIL
Provider Business Practice Location Address City Name:
WEST PALM BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-422-7597
Provider Business Practice Location Address Fax Number:
561-422-7213
Provider Enumeration Date:
08/12/2006