Provider First Line Business Practice Location Address:
6908 W ARGENT RD
Provider Second Line Business Practice Location Address:
B-3
Provider Business Practice Location Address City Name:
PASCO
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99301-2003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-366-0502
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/06/2012