Provider First Line Business Practice Location Address:
1044 MARGARET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PROSSER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99350-1070
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-528-3237
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/07/2024