Provider First Line Business Practice Location Address:
1ST MED BATTALION, 1ST MLG
Provider Second Line Business Practice Location Address:
PO BOX 55657
Provider Business Practice Location Address City Name:
CAMP PENDLETON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
920-946-6601
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/12/2019