Provider First Line Business Practice Location Address:
1550 SOUTH UNION AVE
Provider Second Line Business Practice Location Address:
SUITE 150
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-761-5422
Provider Business Practice Location Address Fax Number:
253-761-5429
Provider Enumeration Date:
08/02/2006