Provider First Line Business Practice Location Address:
BREWSTER BLVD BLDG NH100
Provider Second Line Business Practice Location Address:
USN-NAVAL HOSPITAL
Provider Business Practice Location Address City Name:
CAMP LEJEUNE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28547-0100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-450-4171
Provider Business Practice Location Address Fax Number:
910-450-4952
Provider Enumeration Date:
05/29/2014