Provider First Line Business Practice Location Address:
10310 E BRIDGES RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99009-9664
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-953-4592
Provider Business Practice Location Address Fax Number:
509-292-8656
Provider Enumeration Date:
07/30/2013