Provider First Line Business Practice Location Address:
357140
Provider Second Line Business Practice Location Address:
MARITIME EXPEDITIONARY SECURITY SQUADRON THREE MEDICAL
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
92135-7140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-437-9384
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/18/2012