Provider First Line Business Practice Location Address:
121ST COMBAT SUPPORT HOSPITAL
Provider Second Line Business Practice Location Address:
DEPT OF SURGERY
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96205
Provider Business Practice Location Address Country Code:
KR
Provider Business Practice Location Address Telephone Number:
315-737-6611
Provider Business Practice Location Address Fax Number:
315-737-8110
Provider Enumeration Date:
03/09/2007