Provider First Line Business Practice Location Address:
121ST GENERAL HOSPITAL 18TH MEDICAL COMMAND
Provider Second Line Business Practice Location Address:
UNIT 15281
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96205
Provider Business Practice Location Address Country Code:
KR
Provider Business Practice Location Address Telephone Number:
0118227939421
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/01/2006