Provider First Line Business Practice Location Address:
7211 W DESCHUTES AVE
Provider Second Line Business Practice Location Address:
STE. E
Provider Business Practice Location Address City Name:
KENNEWICK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99336-7728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-735-9239
Provider Business Practice Location Address Fax Number:
509-735-9310
Provider Enumeration Date:
03/02/2006