Provider First Line Business Practice Location Address:
2600 N 20TH AVE
Provider Second Line Business Practice Location Address:
MS T-1
Provider Business Practice Location Address City Name:
PASCO
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-542-4571
Provider Business Practice Location Address Fax Number:
509-544-2025
Provider Enumeration Date:
12/31/2009