Provider First Line Business Practice Location Address:
708 S G ST
Provider Second Line Business Practice Location Address:
TACOMA PUBLIC SCHOOLS DIST #10
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:
253-571-1096
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/04/2012