Provider First Line Business Practice Location Address:
3-10 SOLDIER CENTERED MEDICAL HOME
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT POLK SOUTH
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71459
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-531-4171
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/01/2021