Provider First Line Business Practice Location Address:
9601 STEILACOOM BLVD SW
Provider Second Line Business Practice Location Address:
ATT. PHARMACY
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98498-7213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
125-375-6273
Provider Business Practice Location Address Fax Number:
125-375-6270
Provider Enumeration Date:
12/05/2006