Provider First Line Business Practice Location Address:
2/22 INFANTRYRGT 2 BN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT DRUM
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-423-5149
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/15/2009