Provider First Line Business Practice Location Address:
NMRTU DAM NECK MEDICAL ANNEX
Provider Second Line Business Practice Location Address:
1885 TERRIER AVE., BLDG 504, RM. 125A
Provider Business Practice Location Address City Name:
VIRGINIA BEACH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-953-9848
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/04/2009