Provider First Line Business Practice Location Address:
STENNNIS SPACE CENTER SSC MEDICAL CLINIC
Provider Second Line Business Practice Location Address:
B1100 RM N180W
Provider Business Practice Location Address City Name:
STENNIS SPACE CENTER
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39529-6000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
228-688-3810
Provider Business Practice Location Address Fax Number:
228-688-7565
Provider Enumeration Date:
08/04/2006