Provider First Line Business Practice Location Address: 
GENERAL LEONARD WOOD COMMUNITY HOSPITAL
    Provider Second Line Business Practice Location Address: 
4430 MISSOURI AVE
    Provider Business Practice Location Address City Name: 
FORT LEONARD WOOD
    Provider Business Practice Location Address State Name: 
AA
    Provider Business Practice Location Address Postal Code: 
65473
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
843-743-9072
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
06/22/2020