Provider First Line Business Practice Location Address:
2050 WORTH RD, BLDG 2792, RM 312
Provider Second Line Business Practice Location Address:
HQ USAMEDCOM (MCOP-E)
Provider Business Practice Location Address City Name:
FT. SAM HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78234-6007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-221-6627
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/17/2010