Provider First Line Business Practice Location Address:
NAVY MEDICINE SUPPORT COMMAND, 2005 KNIGHTS LANE
Provider Second Line Business Practice Location Address:
BLDG. H, ATTN: MEDICAL STAFF SERVICES
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-922-9831
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/18/2008