Provider First Line Business Practice Location Address:
52 AREA BRANCH MEDICAL
Provider Second Line Business Practice Location Address:
540450 BASILONE RD
Provider Business Practice Location Address City Name:
CAMP PENDELTON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-763-2421
Provider Business Practice Location Address Fax Number:
760-725-0232
Provider Enumeration Date:
06/09/2014