Provider First Line Business Practice Location Address:
CASEY BAHR, C.O. TRU- SOTAP
Provider Second Line Business Practice Location Address:
16550 177TH AVE SE
Provider Business Practice Location Address City Name:
MONROE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98272
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-794-2440
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/11/2015