Provider First Line Business Practice Location Address:
14TH STREET 13 AREA BRANCH MEDICAL
Provider Second Line Business Practice Location Address:
CLINIC BUILDING 13129
Provider Business Practice Location Address City Name:
CAMP PENDLETON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-725-5912
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/26/2006