Provider First Line Business Practice Location Address:
10830 SE KENT KANGLEY RD
Provider Second Line Business Practice Location Address:
100A
Provider Business Practice Location Address City Name:
KENT
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98030-9959
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-520-7390
Provider Business Practice Location Address Fax Number:
253-520-7028
Provider Enumeration Date:
05/20/2006