Provider First Line Business Practice Location Address:
BLDG 87008, 16TH ST
Provider Second Line Business Practice Location Address:
REGIMENTAL AID STATION
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:
254-553-4126
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/16/2008