Provider First Line Business Practice Location Address:
1006 N YAKIMA AVE
Provider Second Line Business Practice Location Address:
11
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98403-2504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-350-7240
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/19/2008