Provider First Line Business Practice Location Address:
51950 LEAVENWORTH ST.
Provider Second Line Business Practice Location Address:
FAMILY HEALTH CLINIC 22 MDG
Provider Business Practice Location Address City Name:
MCCONNELL AFB
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-417-8100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/26/2017