Provider First Line Business Practice Location Address:
911 S WASHINGTON ST
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
KENNEWICK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99336-5600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-586-2828
Provider Business Practice Location Address Fax Number:
509-586-2525
Provider Enumeration Date:
03/08/2007