Provider First Line Business Practice Location Address:
34101 FARENHOLT AVE
Provider Second Line Business Practice Location Address:
SURFACE WARFARE MEDICINE INSTITUTE
Provider Business Practice Location Address City Name:
SAN DIEGOT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-532-9476
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/29/2008