Provider First Line Business Practice Location Address:
320 N JOHNSON ST
Provider Second Line Business Practice Location Address:
SUITE 900
Provider Business Practice Location Address City Name:
KENNEWICK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99336-2771
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-735-6616
Provider Business Practice Location Address Fax Number:
509-735-6181
Provider Enumeration Date:
03/26/2007