Provider First Line Business Practice Location Address:
MARY BRIDGE CHILDREN'S HOSPITAL
Provider Second Line Business Practice Location Address:
314 MARTIN LUTHER KING JR WAY, SUITE 103
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:
253-403-1434
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/28/2007