Provider First Line Business Practice Location Address:
HEARTWOOD EXTENDED HEALTHCARE
Provider Second Line Business Practice Location Address:
1649 EAST 72ND
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-472-9027
Provider Business Practice Location Address Fax Number:
253-474-9522
Provider Enumeration Date:
07/28/2005