Provider First Line Business Practice Location Address:
503900 MOOTY
Provider Second Line Business Practice Location Address:
13 FISHERMEN BEACHROAD, GARAPAN
Provider Business Practice Location Address City Name:
SAIPAN
Provider Business Practice Location Address State Name:
MP
Provider Business Practice Location Address Postal Code:
96950-3900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
670-235-9090
Provider Business Practice Location Address Fax Number:
670-235-9091
Provider Enumeration Date:
01/11/2007