Provider First Line Business Practice Location Address:
IDES/MEB CLINIC
Provider Second Line Business Practice Location Address:
BLDG 36036 WRATTEN
Provider Business Practice Location Address City Name:
FORT HOOD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76544
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-553-7267
Provider Business Practice Location Address Fax Number:
254-553-7511
Provider Enumeration Date:
08/30/2005