Provider First Line Business Practice Location Address:
MADIGAN ARMY MEDICAL CENTER 9040 REID ST.
Provider Second Line Business Practice Location Address:
ATTN MCHJ-QCR
Provider Business Practice Location Address City Name:
FORT LEWIS
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98431-1110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-968-2252
Provider Business Practice Location Address Fax Number:
253-968-3278
Provider Enumeration Date:
12/15/2006