Provider First Line Business Practice Location Address:
1060 GAFFNEY RD #7440
Provider Second Line Business Practice Location Address:
BASSETT ARMY COMMUNITY HOSPITAL
Provider Business Practice Location Address City Name:
FT. WAINWRIGHT
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99703-7440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-353-5418
Provider Business Practice Location Address Fax Number:
907-353-4845
Provider Enumeration Date:
11/07/2005