Provider First Line Business Practice Location Address:
300 W HOSPITAL RD
Provider Second Line Business Practice Location Address:
BUILDING 300 ROOM 1I-19 OCCUPATIONAL THERAPY CLINIC
Provider Business Practice Location Address City Name:
FORT GORDON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30905-5741
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-787-7448
Provider Business Practice Location Address Fax Number:
706-787-1047
Provider Enumeration Date:
04/18/2008