Provider First Line Business Practice Location Address:
WOMACK ARMY MEDICAL CENTER - DEPT BRAIN INJURY MEDICINE
Provider Second Line Business Practice Location Address:
3908 LONG STREET, BLDG. 3-4303
Provider Business Practice Location Address City Name:
FORT LIBERTY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-907-7709
Provider Business Practice Location Address Fax Number:
910-643-7041
Provider Enumeration Date:
08/17/2006