Provider First Line Business Practice Location Address:
244TH STREET
Provider Second Line Business Practice Location Address:
SUITE B BALLINGER PRIMARY CARE
Provider Business Practice Location Address City Name:
MOUNTLAKE TERRACE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98043-9999
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-640-4830
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/23/2010