Provider First Line Business Practice Location Address:
6710 W OKANOGAN PL
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:
99336-8001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-783-2000
Provider Business Practice Location Address Fax Number:
509-783-2008
Provider Enumeration Date:
10/01/2012