Provider First Line Business Practice Location Address:
9040 JACKSON AVE
Provider Second Line Business Practice Location Address:
ATTN: MCHJ-CLQ-C MADIGAN ARMY 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:
98431-1000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-967-9818
Provider Business Practice Location Address Fax Number:
253-967-2639
Provider Enumeration Date:
03/25/2016