Provider First Line Business Practice Location Address:
121ST GENERAL HOSPITAL
Provider Second Line Business Practice Location Address:
BOX 626
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96205-0054
Provider Business Practice Location Address Country Code:
KR
Provider Business Practice Location Address Telephone Number:
01182279175430
Provider Business Practice Location Address Fax Number:
01182279177021
Provider Enumeration Date:
08/07/2006