Provider First Line Business Practice Location Address:
1409 N. PITTSBURGH ST.
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
KENNEWICK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99336
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-783-0927
Provider Business Practice Location Address Fax Number:
509-783-0424
Provider Enumeration Date:
09/25/2006