Provider First Line Business Practice Location Address:
VA-CBOC GUAM
Provider Second Line Business Practice Location Address:
US NAVAL HOSPITAL
Provider Business Practice Location Address City Name:
AGANA HEIGHTS
Provider Business Practice Location Address State Name:
GUAM USA
Provider Business Practice Location Address Postal Code:
96919
Provider Business Practice Location Address Country Code:
UM
Provider Business Practice Location Address Telephone Number:
671-344-9478
Provider Business Practice Location Address Fax Number:
671-472-7249
Provider Enumeration Date:
06/25/2006