Provider First Line Business Practice Location Address:
DEPARTMENT OF THE ARMY WAMC STOP A 2817 REILLY ROAD
Provider Second Line Business Practice Location Address:
ATTN: SUN YONG KIM MCXC-RAD
Provider Business Practice Location Address City Name:
FORT BRAGG
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28310-7301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-907-6993
Provider Business Practice Location Address Fax Number:
910-907-6985
Provider Enumeration Date:
02/13/2006