Provider First Line Business Practice Location Address:
CAMP SHELBY
Provider Second Line Business Practice Location Address:
TROOP MEDICAL CLINIC BLDG 1302
Provider Business Practice Location Address City Name:
CAMP SHELBY
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39407-5500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-558-2221
Provider Business Practice Location Address Fax Number:
601-558-2445
Provider Enumeration Date:
11/09/2006