Provider First Line Business Practice Location Address:
1901 SO UNION
Provider Second Line Business Practice Location Address:
STE A305 ALLENMORE MEDICAL CENTER
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-272-3031
Provider Business Practice Location Address Fax Number:
253-272-9449
Provider Enumeration Date:
08/05/2007