Provider First Line Business Practice Location Address:
BLDG 2245 58TH ST AND 761 ST TANK BN AVE
Provider Second Line Business Practice Location Address:
CHARLES T MOORE CLINIC
Provider Business Practice Location Address City Name:
FORT HOOD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76544-4752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-287-5410
Provider Business Practice Location Address Fax Number:
254-285-6193
Provider Enumeration Date:
08/19/2006