Provider First Line Business Practice Location Address:
2050 WORTH ROAD
Provider Second Line Business Practice Location Address:
SUITE 10 HQ MEDCOM ATTN DR ORMAN
Provider Business Practice Location Address City Name:
FORT SAM HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78234-6010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-221-6792
Provider Business Practice Location Address Fax Number:
210-221-6894
Provider Enumeration Date:
07/07/2005