Provider First Line Business Practice Location Address:
1708 S. YAKIMA AVE.,
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-565-6777
Provider Business Practice Location Address Fax Number:
253-565-8777
Provider Enumeration Date:
04/05/2011