Provider First Line Business Practice Location Address:
9040 JACKSON AVENUE
Provider Second Line Business Practice Location Address:
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:
98431-1100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-968-2235
Provider Business Practice Location Address Fax Number:
253-968-0525
Provider Enumeration Date:
03/15/2016