Provider First Line Business Practice Location Address:
BUREAU OF MEDICINE & SURGERY DETACHMENT JACKSONVILLE
Provider Second Line Business Practice Location Address:
NAS JACKSONVILLE
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32212-0140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-727-3649
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/27/2012