Provider First Line Business Practice Location Address:
1 COULEE BOULEVARD WEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELECTRIC CITY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-633-9915
Provider Business Practice Location Address Fax Number:
888-316-6792
Provider Enumeration Date:
08/05/2008