Provider First Line Business Practice Location Address:
820 MEMORIAL ST., STE 3
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-786-5599
Provider Business Practice Location Address Fax Number:
209-342-3743
Provider Enumeration Date:
09/14/2007