Provider First Line Business Practice Location Address:
881 USS JAMES MADISON RD
Provider Second Line Business Practice Location Address:
NSSC UNDERSEA MEDICAL DEPARTMENT
Provider Business Practice Location Address City Name:
KINGS BAY
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31547-2531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-573-2995
Provider Business Practice Location Address Fax Number:
912-573-4534
Provider Enumeration Date:
01/26/2006