Provider First Line Business Practice Location Address:
7350 W DESCHUTES AVE
Provider Second Line Business Practice Location Address:
BLDG A
Provider Business Practice Location Address City Name:
KENNEWICK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99336-7802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-783-9894
Provider Business Practice Location Address Fax Number:
509-783-3194
Provider Enumeration Date:
09/14/2006