Provider First Line Business Practice Location Address:
365 W. 3RD AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KETTLE FALLS
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-675-3099
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/01/2021