Provider First Line Business Practice Location Address:
MADIAGN ARMY MEDICAL CENTER
Provider Second Line Business Practice Location Address:
MCHJ-FP (AVN MED)
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:
253-968-4600
Provider Business Practice Location Address Fax Number:
253-968-2608
Provider Enumeration Date:
06/22/2006