Provider First Line Business Practice Location Address:
APHN MAMC MCHJ-PV-C/ CPT MERRILL
Provider Second Line Business Practice Location Address:
BLDG. 9912-B (OMAMC) E. JOHNSON ST.
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98431-1100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-968-4382
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/06/2007