Provider First Line Business Practice Location Address:
4218 S STEELE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98409-7312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-682-4100
Provider Business Practice Location Address Fax Number:
253-472-4140
Provider Enumeration Date:
04/11/2007