Provider First Line Business Practice Location Address:
358 N MAIN ST
Provider Second Line Business Practice Location Address:
C/O COLVILLE COMMUNITY HEALTH CENTER
Provider Business Practice Location Address City Name:
COLVILLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-684-1440
Provider Business Practice Location Address Fax Number:
509-935-8406
Provider Enumeration Date:
04/28/2015