Provider First Line Business Practice Location Address:
4309 W. 27TH PL.
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
KENNEWICK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99338
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-735-5433
Provider Business Practice Location Address Fax Number:
509-735-5435
Provider Enumeration Date:
08/18/2006