Provider First Line Business Practice Location Address:
MADIGAN ARMY MEDICAL CENTER ATTN: CREDENTIALS OFFICE
Provider Second Line Business Practice Location Address:
9040 JACKSON AVE
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-969-2252
Provider Business Practice Location Address Fax Number:
235-968-3278
Provider Enumeration Date:
12/27/2005