Provider First Line Business Practice Location Address:
77 WAINWRIGHT DR
Provider Second Line Business Practice Location Address:
VAMC EYE CLINIC, 123
Provider Business Practice Location Address City Name:
WALLA WALLA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99362-3975
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-527-3491
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/07/2005