Provider First Line Business Practice Location Address:
210 W. MAIN
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:
99169-0438
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-659-4800
Provider Business Practice Location Address Fax Number:
509-659-4801
Provider Enumeration Date:
07/29/2006