Provider First Line Business Practice Location Address:
BLDG H2005 KNIGHT LANE
Provider Second Line Business Practice Location Address:
NAVY MEDICINE SUPPORT COMMAND
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-450-4136
Provider Business Practice Location Address Fax Number:
910-450-4558
Provider Enumeration Date:
12/08/2008