Provider First Line Business Practice Location Address:
3180 W CLEARWATER AVE STE E
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-543-8500
Provider Business Practice Location Address Fax Number:
509-783-4455
Provider Enumeration Date:
07/11/2008