Provider First Line Business Practice Location Address:
BUILDING HP217 F ST
Provider Second Line Business Practice Location Address:
BATTALION AID STATION 1ST BATTALION 2ND MARINES
Provider Business Practice Location Address City Name:
CAMP LEJEUNE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28542-0094
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-451-3607
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/27/2009