Provider First Line Business Practice Location Address:
2005 KNIGHT LANE, MEDICAL STAFF SERVICES BLDG. H
Provider Second Line Business Practice Location Address:
NAVY MEDICINE SUPPORT COMMAND
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32212-0140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-542-7200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/20/2006