Provider First Line Business Practice Location Address:
903 S AUBURN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENNEWICK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99336-5662
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-582-8225
Provider Business Practice Location Address Fax Number:
509-582-2893
Provider Enumeration Date:
06/14/2006