Provider First Line Business Practice Location Address:
NMRTC TWENTYNINE PALMS 1145 STURGIS ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TWENTYNINE PALMS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92278
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-532-5761
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/01/2022