Provider First Line Business Practice Location Address:
1060 GAFFNEY RD STOP 7420
Provider Second Line Business Practice Location Address:
MEDDAC-AK
Provider Business Practice Location Address City Name:
FT WAINWRIGHT
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99703-5007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-361-6059
Provider Business Practice Location Address Fax Number:
907-361-6151
Provider Enumeration Date:
04/27/2017