Provider First Line Business Practice Location Address:
USAMEDDAC WUERZBURG UNIT 26610
Provider Second Line Business Practice Location Address:
ATTN: CREDENTIALS OFFICE
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
011499318043932
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/15/2006