Organization
FOUNTAIN OF LIFE WELLNESS CENTER
Active
Other names
Fountain of Life Center
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA MILEWSKI (EXECUTIVE DIRECTOR)
(253) 380-5263
Entity
Organization
Contact information
Practice address
1314 72ND ST E, TACOMA, WA 98404-3343
(253) 380-5263
Mailing address
14010 68TH AVE E, PUYALLUP, WA 98373-8706
(253) 380-5263
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
602786502
WA
Other
Enumeration date
06/27/2010
Last updated
06/27/2010
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