Provider First Line Business Practice Location Address:
820 HARVEY RD
Provider Second Line Business Practice Location Address:
SUITE F
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98002-4247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-833-3278
Provider Business Practice Location Address Fax Number:
253-804-4620
Provider Enumeration Date:
02/27/2007