Provider First Line Business Practice Location Address:
2005 KNIGHT LANE BUILDING H
Provider Second Line Business Practice Location Address:
NAVY MEDICINE SUPPORT COMMAND ATTENTION MEDICAL STAFF
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
32212-0140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-725-3213
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/15/2014