Provider First Line Business Practice Location Address:
BUILDING R-3742, RAILROAD AVE.
Provider Second Line Business Practice Location Address:
1-2 EMBEDDED BEHAVIORAL HEALTH
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:
98498-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-966-3640
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/29/2006