Provider First Line Business Practice Location Address:
8TH REGIMENTAL AID STATION
Provider Second Line Business Practice Location Address:
2ND MARINE DIVISION
Provider Business Practice Location Address City Name:
CAMP LEJEUNE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28542-0101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-451-5515
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2007