Provider First Line Business Practice Location Address:
401 W POPLAR ST
Provider Second Line Business Practice Location Address:
ST MARY MEDICAL CENTER, CARDIOLOGY SUITE
Provider Business Practice Location Address City Name:
WALLA WALLA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99362-2846
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-897-2600
Provider Business Practice Location Address Fax Number:
509-897-5747
Provider Enumeration Date:
05/23/2006