Provider First Line Business Practice Location Address:
USS EMORY S LAND (AS 39)
Provider Second Line Business Practice Location Address:
UNIT 100104 - MSC MEDICAL
Provider Business Practice Location Address City Name:
FPO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96667
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-687-9677
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/15/2006