Provider First Line Business Practice Location Address:
U.S. ARMY FAMILY AND MWR
Provider Second Line Business Practice Location Address:
BLDG # 2494 RICKER ROAD, FORT BLISS
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-569-7758
Provider Business Practice Location Address Fax Number:
915-568-4357
Provider Enumeration Date:
09/22/2006