Provider First Line Business Practice Location Address:
AMERICAN LAKE VA
Provider Second Line Business Practice Location Address:
9600 VETERANS DRIVE
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98493-5000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-582-8440
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/15/2006