Provider First Line Business Practice Location Address:
BRACH MEDICAL CLINIC
Provider Second Line Business Practice Location Address:
NAVAL SUPPORT ACTIVITY MID-SOUTH
Provider Business Practice Location Address City Name:
MILLINGTON
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-874-6100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/29/2006