Provider First Line Business Practice Location Address:
DAVID GRANT USAF MEDICAL CENTER'S MCCLELLAN OUTPATIENT
Provider Second Line Business Practice Location Address:
5342 DUDLEY BLVD
Provider Business Practice Location Address City Name:
MCCLELLAN PARK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-561-7560
Provider Business Practice Location Address Fax Number:
916-561-7566
Provider Enumeration Date:
04/24/2008