Provider First Line Business Practice Location Address:
238 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PULLMAN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99163-2619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-334-1131
Provider Business Practice Location Address Fax Number:
509-332-4062
Provider Enumeration Date:
11/03/2006