Provider First Line Business Practice Location Address:
588 SE BISHOP BLVD STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PULLMAN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99163-5534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-332-7778
Provider Business Practice Location Address Fax Number:
509-332-7032
Provider Enumeration Date:
08/29/2006