Provider First Line Business Practice Location Address:
BLDG. 9040 FITZSIMMONS DRIVE
Provider Second Line Business Practice Location Address:
MADIGAN ARMY MEDICAL CENTER, DEPT OF PEDIATRICS
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98431-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-968-1980
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/06/2006