Provider First Line Business Practice Location Address:
18TH MEDICAL COMMAND
Provider Second Line Business Practice Location Address:
BOX 68 UNIT 15821
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96205-5281
Provider Business Practice Location Address Country Code:
KR
Provider Business Practice Location Address Telephone Number:
01182279177172
Provider Business Practice Location Address Fax Number:
01182279168005
Provider Enumeration Date:
12/28/2005