Provider First Line Business Practice Location Address:
14TH MEDICAL GROUP, COLUMBUS MILITARY MEDICAL GROUP
Provider Second Line Business Practice Location Address:
201 INDEPENDENCE DRIVE, BLDG 1100,
Provider Business Practice Location Address City Name:
COLUMBUS AFB
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39710-5300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-434-2239
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/16/2007