Provider First Line Business Practice Location Address:
14491 N THORP HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
THORP
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98946-9554
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-964-2086
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/20/2008