Provider First Line Business Practice Location Address:
301 ANDREWS AVENUE, EYE AND EAR CLINIC (EENT)
Provider Second Line Business Practice Location Address:
LYSTER ARMY HEALTH CLINIC
Provider Business Practice Location Address City Name:
FT. RUCKER
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-255-7185
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/23/2011