Provider First Line Business Practice Location Address:
690 BARNES BOULEVARD
Provider Second Line Business Practice Location Address:
MCCHORD AFB AIRMEN'S CLINIC
Provider Business Practice Location Address City Name:
JOINT BASE LEWIS MCCHORD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98438-1304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-982-7973
Provider Business Practice Location Address Fax Number:
253-982-0332
Provider Enumeration Date:
03/26/2010