Provider First Line Business Practice Location Address:
4076 NEELY ROAD BLDG. 4076, ROOM 3C-401
Provider Second Line Business Practice Location Address:
BASSETT ARMY COMMUNITY HOSPITAL
Provider Business Practice Location Address City Name:
FT WAINWRIGHT
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99703-7440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-361-5603
Provider Business Practice Location Address Fax Number:
907-361-4847
Provider Enumeration Date:
09/18/2015