Provider First Line Business Practice Location Address:
115 W KENNEWICK AVE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
KENNEWICK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99336-3831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-586-9700
Provider Business Practice Location Address Fax Number:
509-735-5397
Provider Enumeration Date:
02/16/2011