Provider First Line Business Practice Location Address:
SAN ANTONIO MILITARY MEDICAL CENTER
Provider Second Line Business Practice Location Address:
3851 ROGER BROOKE DR.
Provider Business Practice Location Address City Name:
SA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-916-1245
Provider Business Practice Location Address Fax Number:
210-916-2946
Provider Enumeration Date:
10/28/2005