Provider First Line Business Practice Location Address:
30TH MEDICAL GROUP, 338 SOUTH DAKOTA
Provider Second Line Business Practice Location Address:
BUILDING 13850
Provider Business Practice Location Address City Name:
VANDENBERG SPACE FORCE BASE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93437-5300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-606-1721
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/27/2020