Provider First Line Business Practice Location Address:
MADIGAN ARMY MEDICAL CTR
Provider Second Line Business Practice Location Address:
CREDENTIALS OFFICE
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:
253-968-0982
Provider Business Practice Location Address Fax Number:
253-968-3278
Provider Enumeration Date:
05/20/2006