Provider First Line Business Practice Location Address:
26311 E. TRENT AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWMAN LAKE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-499-2015
Provider Business Practice Location Address Fax Number:
509-226-5229
Provider Enumeration Date:
04/03/2013