Provider First Line Business Practice Location Address:
#5447 FHP AND PREVENTIVE MEDICINE, YONGSAN. 96205
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-736-6692
Provider Business Practice Location Address Fax Number:
315-736-3028
Provider Enumeration Date:
11/19/2011