Provider First Line Business Practice Location Address:
H100 SANTA MARGERITA RD
Provider Second Line Business Practice Location Address:
NAVAL HOSPITAL CAMP PENDLETON
Provider Business Practice Location Address City Name:
CAMP PENDLETON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-343-4656
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/07/2006