Provider First Line Business Practice Location Address:
5979 DESERT STORM AVE
Provider Second Line Business Practice Location Address:
LAPOINTE HEALTH CLINIC
Provider Business Practice Location Address City Name:
FORT CAMPBELL
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42223-5585
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-420-0091
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/31/2009