Provider First Line Business Practice Location Address:
300 S 7TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUNNYSIDE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98944-1503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-818-3337
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/13/2007