Provider First Line Business Practice Location Address:
825 SE BISHOP BLVD
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
PULLMAN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99163-5517
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-332-2828
Provider Business Practice Location Address Fax Number:
509-334-7474
Provider Enumeration Date:
08/19/2015