Provider First Line Business Practice Location Address:
9933 WEST HAYES STREET, OLD MADIGAN
Provider Second Line Business Practice Location Address:
NATIONAL CENTER FOR TELEHEALTH & TECHNOLOGY (T2)
Provider Business Practice Location Address City Name:
JOINT BASE LEWIS-MCCHORD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-402-3686
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/28/2012