Provider First Line Business Practice Location Address:
100 SOUTH FIRST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRINGTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-253-4331
Provider Business Practice Location Address Fax Number:
509-456-6306
Provider Enumeration Date:
07/06/2006