Provider First Line Business Practice Location Address:
BRANCH MEDICAL CLINIC
Provider Second Line Business Practice Location Address:
NAS NORTH ISLAND BOX 357046
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92135-7046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-545-4263
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/14/2006