Provider First Line Business Practice Location Address:
8601 E. B ST.
Provider Second Line Business Practice Location Address:
LATCHMONT ELEMENTARY SCHOOL
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-571-6200
Provider Business Practice Location Address Fax Number:
253-571-6262
Provider Enumeration Date:
10/26/2012