Provider First Line Business Practice Location Address:
MADIGAN ARMY MEDICAL CTR 9040 JACKSON AVENUE
Provider Second Line Business Practice Location Address:
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:
98431-1110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-239-8612
Provider Business Practice Location Address Fax Number:
785-239-7364
Provider Enumeration Date:
09/08/2006