Provider First Line Business Practice Location Address:
700 24TH STREET
Provider Second Line Business Practice Location Address:
KENNER ARMY HEALTH CLINIC
Provider Business Practice Location Address City Name:
FORT GREGG- ADAMS
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23801-1716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-734-9057
Provider Business Practice Location Address Fax Number:
804-734-9289
Provider Enumeration Date:
02/22/2006