Provider First Line Business Practice Location Address:
15701 B STREET EAST
Provider Second Line Business Practice Location Address:
HEALTH ROOM
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-683-5468
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/28/2019