Provider First Line Business Practice Location Address:
515 W COURT ST
Provider Second Line Business Practice Location Address:
CHC LA CLINICA
Provider Business Practice Location Address City Name:
PASCO
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-547-2209
Provider Business Practice Location Address Fax Number:
509-544-8768
Provider Enumeration Date:
02/09/2006