Provider First Line Business Practice Location Address:
1650 COCHRANE CIR
Provider Second Line Business Practice Location Address:
DEPT OF BEHAVIORAL HEALTH
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:
253-282-3860
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/04/2006