Provider First Line Business Practice Location Address:
504 SCOTT ST
Provider Second Line Business Practice Location Address:
U.S. ARMY MED RESEARCH & MATERIEL CMD
Provider Business Practice Location Address City Name:
FORT DETRICK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21702-9218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-619-8474
Provider Business Practice Location Address Fax Number:
301-619-5034
Provider Enumeration Date:
11/06/2012