Provider First Line Business Practice Location Address:
2411 S. UNION ST.
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
KENNEWICK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99338
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-783-7242
Provider Business Practice Location Address Fax Number:
509-783-7286
Provider Enumeration Date:
03/06/2007