Provider First Line Business Practice Location Address:
MEDICAL TREATMENT FACILITY
Provider Second Line Business Practice Location Address:
USNS MERCY T AH 19
Provider Business Practice Location Address City Name:
FPO AP
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96672-4090
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-767-6226
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/18/2011