Provider First Line Business Practice Location Address:
OCCUPATIONAL HEALTH FACILITY
Provider Second Line Business Practice Location Address:
BUILDING M6-495, MAIL CODE NEM-005
Provider Business Practice Location Address City Name:
KENNEDY SPACE CENTER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32899
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
321-867-2025
Provider Business Practice Location Address Fax Number:
321-867-2040
Provider Enumeration Date:
07/29/2008