Provider First Line Business Practice Location Address:
308 W WILLIS STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRINGTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99134-0665
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-253-4333
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/05/2007