Provider First Line Business Practice Location Address:
19119 NORTH CREEK PKWY SUITE 107
Provider Second Line Business Practice Location Address:
TAI - CANYON PARK SPORT & SPINE PHYSICAL THERAPY
Provider Business Practice Location Address City Name:
BOTHELL
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98011-8036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-489-3420
Provider Business Practice Location Address Fax Number:
425-489-3421
Provider Enumeration Date:
07/03/2006