Provider First Line Business Practice Location Address:
MADICAN ARMY MEDICAL CENTER 9040 JACKSON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOINT BASE LEWIS MCCHORD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98431-5275
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-615-4193
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/30/2006