Provider First Line Business Practice Location Address:
VA PSHCS, AMERICAN LK. DIV. (A-116-ATC)
Provider Second Line Business Practice Location Address:
9600 VETERANS DR. S.W.
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98493
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-583-1661
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/16/2006