Provider First Line Business Practice Location Address:
621 LINWOOD AVE SW
Provider Second Line Business Practice Location Address:
TUMWATER SCHOOL DISTRICT
Provider Business Practice Location Address City Name:
TUMWATER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98512-6847
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-709-7040
Provider Business Practice Location Address Fax Number:
360-709-7042
Provider Enumeration Date:
11/16/2015