Provider First Line Business Practice Location Address:
2435 STEVENS CENTER PLACE
Provider Second Line Business Practice Location Address:
WTP MEDCOR MEDICAL FACILITY
Provider Business Practice Location Address City Name:
RICHLAND
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-373-8204
Provider Business Practice Location Address Fax Number:
509-373-8370
Provider Enumeration Date:
05/28/2010