Provider First Line Business Practice Location Address:
35TH MEDICAL GROUP
Provider Second Line Business Practice Location Address:
UNIT 5024 BLDG 99
Provider Business Practice Location Address City Name:
MISAWA AIR BASE
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96319
Provider Business Practice Location Address Country Code:
JP
Provider Business Practice Location Address Telephone Number:
317-226-6647
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/30/2006