Provider First Line Business Practice Location Address:
1410 N PITTSBURG ST STE A
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:
99336-8211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-662-1955
Provider Business Practice Location Address Fax Number:
509-662-6695
Provider Enumeration Date:
04/09/2007