Provider First Line Business Practice Location Address:
PSC 557 BOX 1640
Provider Second Line Business Practice Location Address:
US NAVAL HOSPITAL-OKINAWA
Provider Business Practice Location Address City Name:
FPO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96379
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
611-746-2228
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/24/2006