Provider First Line Business Practice Location Address:
5005 N PIEDRAS ST.
Provider Second Line Business Practice Location Address:
WILLIAM BEAUMONT ARMY MEDICAL CENTER (WBAMC)
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79920
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-408-2723
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/25/2015