Provider First Line Business Practice Location Address:
BOX 359612
Provider Second Line Business Practice Location Address:
DEPT. OF REHABILITATION MEDICINE, 325 NINTH AVE
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98104-2499
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-523-3831
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/10/2013