Provider First Line Business Practice Location Address:
216 W 10TH AVE
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
KENNEWICK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99336-6300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-585-5990
Provider Business Practice Location Address Fax Number:
509-585-5992
Provider Enumeration Date:
05/17/2006