Provider First Line Business Practice Location Address:
2DN & LIGGETT ST. BLDING 2006A, MCHJ-DA
Provider Second Line Business Practice Location Address:
ARMY SUBSTANCE ABUSE PROGRAM/MAMC
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98431-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-967-1452
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/28/2006