Provider First Line Business Practice Location Address:
DEPT OF DEPLOYMENT HEALTH WOMC
Provider Second Line Business Practice Location Address:
PHYSICAL EXAM
Provider Business Practice Location Address City Name:
FORT BRAGG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-907-6390
Provider Business Practice Location Address Fax Number:
910-907-8451
Provider Enumeration Date:
03/20/2006