Provider First Line Business Practice Location Address:
121ST COMBAT SUPPORT HOSPITAL 611
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96205
Provider Business Practice Location Address Country Code:
KR
Provider Business Practice Location Address Telephone Number:
82279184422
Provider Business Practice Location Address Fax Number:
79184425
Provider Enumeration Date:
04/02/2007