Provider First Line Business Practice Location Address:
FORT GEORGE G. MEADE MEDDAC
Provider Second Line Business Practice Location Address:
2480 LLEWELLYN AVE/SUITE 5800
Provider Business Practice Location Address City Name:
FORT MEADE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20755-5129
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-278-1763
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/14/2005