Provider First Line Business Practice Location Address:
DEPARTMENT OF THE ARMY
Provider Second Line Business Practice Location Address:
15244
Provider Business Practice Location Address City Name:
SOEUL
Provider Business Practice Location Address State Name:
YOUNGSUN
Provider Business Practice Location Address Postal Code:
APO AP 96205
Provider Business Practice Location Address Country Code:
KR
Provider Business Practice Location Address Telephone Number:
82279175400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/15/2009