Provider First Line Business Practice Location Address:
GLWACH,GEN LEONARD WOOD ARMY COM HOSPITAL
Provider Second Line Business Practice Location Address:
128 MISSOURI AVE
Provider Business Practice Location Address City Name:
FT LEONARD WOOD
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65473
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-596-1761
Provider Business Practice Location Address Fax Number:
573-596-0559
Provider Enumeration Date:
11/17/2007