Provider First Line Business Practice Location Address:
UNIT 28755 BOX 6546
Provider Second Line Business Practice Location Address:
USAHC KTB - BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09177-8755
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-468-7200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/26/2015