Provider First Line Business Practice Location Address:
215 6TH AVE N
Provider Second Line Business Practice Location Address:
BIOSPORTS NORTHWEST
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-956-9300
Provider Business Practice Location Address Fax Number:
206-956-9462
Provider Enumeration Date:
02/13/2007