Provider First Line Business Practice Location Address:
3730 PLAZA WAY STE 6500
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:
99338-2718
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-585-3622
Provider Business Practice Location Address Fax Number:
509-585-3624
Provider Enumeration Date:
12/08/2006