Provider First Line Business Practice Location Address:
USAMEDDAC WUERZBURG ATTN: CREDENTIALS OFFICE UNIT
Provider Second Line Business Practice Location Address:
UNIT 26610
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
AE
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
011499318043616
Provider Business Practice Location Address Fax Number:
011499318043616
Provider Enumeration Date:
08/24/2006