Provider First Line Business Practice Location Address:
19881 STATE ROUTE 2
Provider Second Line Business Practice Location Address:
ALBERTSON'S SAV-ON
Provider Business Practice Location Address City Name:
MONROE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98272-2352
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-794-5870
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/21/2012