Provider First Line Business Practice Location Address:
USS SHOUP (DDG 86)
Provider Second Line Business Practice Location Address:
ATTN: MEDICAL DEPARTMENT
Provider Business Practice Location Address City Name:
FPO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96678-1300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-304-5030
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/16/2012