Provider First Line Business Practice Location Address:
902 S ADAMS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RITZVILLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99169-2228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-448-2389
Provider Business Practice Location Address Fax Number:
888-868-4804
Provider Enumeration Date:
10/27/2006