Provider First Line Business Practice Location Address:
3908 S AUBURN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENNEWICK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99337-5146
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-430-5872
Provider Business Practice Location Address Fax Number:
888-948-5923
Provider Enumeration Date:
08/06/2007