Provider First Line Business Practice Location Address:
590 MEDICAL CENTER ROAD
Provider Second Line Business Practice Location Address:
ALLERGY / IMMUNOLOGY CLINIC
Provider Business Practice Location Address City Name:
FORT HOOD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76544
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-285-6335
Provider Business Practice Location Address Fax Number:
254-618-1008
Provider Enumeration Date:
10/23/2009