Provider First Line Business Practice Location Address:
6443 NE 181ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENMORE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98028-4831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-203-1331
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/12/2008