Provider First Line Business Practice Location Address:
2136 MARTIN LUTHER KING JR WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98405-3838
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-572-3214
Provider Business Practice Location Address Fax Number:
253-572-5880
Provider Enumeration Date:
06/29/2022