Provider First Line Business Practice Location Address:
900 S AUBURN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENNEWICK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99336-5621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-586-5779
Provider Business Practice Location Address Fax Number:
509-586-5178
Provider Enumeration Date:
07/13/2010