Provider First Line Business Practice Location Address:
121 COMBAT SUPPORT HOSPITAL
Provider Second Line Business Practice Location Address:
BOX # 27
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96205-5244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
01182279174633
Provider Business Practice Location Address Fax Number:
01182279176895
Provider Enumeration Date:
10/23/2005