Provider First Line Business Practice Location Address:
9040A FITZSIMMONS DR
Provider Second Line Business Practice Location Address:
INTERNAL MEDICINE CLINIC - MAMC
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98431-1100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-968-5154
Provider Business Practice Location Address Fax Number:
253-968-5154
Provider Enumeration Date:
01/28/2009