Provider First Line Business Practice Location Address:
400 FAIRCHILD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRCHILD AFB
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99011-2088
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-565-3607
Provider Business Practice Location Address Fax Number:
509-565-3601
Provider Enumeration Date:
08/12/2024