Provider First Line Business Practice Location Address:
3700 W CLEARWATER AVE
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-735-1312
Provider Business Practice Location Address Fax Number:
506-736-6403
Provider Enumeration Date:
01/26/2007