Provider First Line Business Practice Location Address:
600 CAISSON HILL RD
Provider Second Line Business Practice Location Address:
IRWIN ARMY HOSPITAL, IDES CLINIC
Provider Business Practice Location Address City Name:
FORT RILEY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66442
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-240-7643
Provider Business Practice Location Address Fax Number:
785-239-2705
Provider Enumeration Date:
03/31/2006