Provider First Line Business Practice Location Address:
9481 WILDERNESS RD, EBHT 4
Provider Second Line Business Practice Location Address:
EVANS ARMY COMMUNITY HOSPITAL, DEPT OF BH
Provider Business Practice Location Address City Name:
FORT CARSON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-526-2542
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/01/2006