Provider First Line Business Practice Location Address:
1831 S BARKER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENACRES
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99016-9762
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-951-2927
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/01/2014