Provider First Line Business Practice Location Address:
1500 COCHRANE CR
Provider Second Line Business Practice Location Address:
DEPT BEHAV HEALTH
Provider Business Practice Location Address City Name:
FT CARSON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-526-7155
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/17/2006