Provider First Line Business Practice Location Address:
EVANS ARMY COMMUNITY HOSPITAL USA MEDDAC
Provider Second Line Business Practice Location Address:
DIRAIMONDO FAMILY MEDICINE CLINIC
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:
719-524-2047
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/12/2007