Provider First Line Business Practice Location Address:
TWENTYNINE PALMS MARINE BASE
Provider Second Line Business Practice Location Address:
1591
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AA
Provider Business Practice Location Address Postal Code:
92278
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-830-6000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/20/2019