Provider First Line Business Practice Location Address:
9040 FITZSIMMONS DR
Provider Second Line Business Practice Location Address:
MADIGAN ARMY MEDICAL CENTER
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98433-1100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-968-1351
Provider Business Practice Location Address Fax Number:
253-968-3731
Provider Enumeration Date:
03/23/2006