Provider First Line Business Practice Location Address:
1 AYRES CIRCLE
Provider Second Line Business Practice Location Address:
NAVAL BRANCH HEALTH CLINIC BUILDING H-1
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-438-5981
Provider Business Practice Location Address Fax Number:
207-438-1527
Provider Enumeration Date:
03/28/2006