Provider First Line Business Practice Location Address:
HHC 121ST COMBAT SUPPORT HOSPITAL, BOX # 649
Provider Second Line Business Practice Location Address:
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:
821192821749
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/04/2006