Provider First Line Business Practice Location Address:
DEPT OF PREVENTIVE MEDICINE
Provider Second Line Business Practice Location Address:
DDEAMC
Provider Business Practice Location Address City Name:
FORT GORDON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-787-5124
Provider Business Practice Location Address Fax Number:
706-787-0511
Provider Enumeration Date:
05/23/2006