Provider First Line Business Practice Location Address:
125 S WEHE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PASCO
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99301-4331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-543-6086
Provider Business Practice Location Address Fax Number:
509-543-6087
Provider Enumeration Date:
09/21/2022