Provider First Line Business Practice Location Address:
550 POPE AVE
Provider Second Line Business Practice Location Address:
MUNSON ARMY MEDICAL CENTER
Provider Business Practice Location Address City Name:
LEAVENWORTH
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66027-2332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-910-2159
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/10/2006