Provider First Line Business Practice Location Address:
EVANS ARMY COMUNITY HOSPITAL
Provider Second Line Business Practice Location Address:
PREMIER MEDICAL HOME
Provider Business Practice Location Address City Name:
FT CARSON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80913-4604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-524-7601
Provider Business Practice Location Address Fax Number:
719-524-3526
Provider Enumeration Date:
12/11/2006