Provider First Line Business Practice Location Address:
USAMEDDAC WUERZBURG
Provider Second Line Business Practice Location Address:
ATTEN: CREDENTIALS UNIT 26610
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09244
Provider Business Practice Location Address Country Code:
DE
Provider Business Practice Location Address Telephone Number:
01149964183
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/19/2005